ECG Quiz 45

ECG Quiz 45

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Discussion

Negative P, QRS and T in I and aVL with progressive decrease in QRS amplitude from V1-V6 is suggestive of dextrocardia with situs inversus. Along with bronchiectasis, it becomes Kartagener syndrome (also called immotile ciliary syndrome) an autosomal recessive genetic disorder. The ciliary motility of respiratory tract, paranasal sinuses, middle ear, Eustachian tube and Fallopian tube can be affected. Sperm motility can also be affected by involvement of the flagellum. Rather than being fully immotile it is inefficient or asynchronous movement of the cilia. Infertility, sinusitis and bronchiectasis are the features which may manifest to a variable extend.

Kartagener syndrome
Kartagener syndrome

Chest X-ray shows dextrocardia with situs inversus (gastric air bubble on right side, liver shadow on left side, aortic knuckle on right side) and features of bronchiectasis in the lower zones.