ECG findings in VSD
ECG is normal with small ventricular septal defects. Left atrial enlargement may be noted in moderately restrictive VSDs and in those with large left to right shunts. Left axis deviation is common with inlet VSDs and AV septal defects. Left axis deviation may also be seen in about five percent of moderately restrictive VSDs. Ventricular septal aneurysms and multiple VSDs (Swiss cheese ventricular septum) can be associated with left axis deviation. Biventricular enlargement (Katz – Wachtel phenomenon) can be seen in large VSD. The Katz-Wachtel sign is tall diphasic RS complexes at least 50 mm in height in lead V2, V3 or V4 – mid precordial leads.
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