ISIFUNDAZWE SAKWAZULU
P ie t er m ar i t zb u r g EMPILO
Me tr op o l it a n
Hos p it a ls Com p lex KWAZULU-NATAL PROVINSIE
GESONDHEIDSDIENSTE
W H Y DO A PA E D I ATR I C E CG ?
You may be clever enough to make an anatomical diagnosis, but no cardiac assessment is
complete without a determination of haemodynamic significance, and a ruling out of possible
associations.
Cardiac
assessment
Haemodynamic
Diagnosis Associations
significance
Growth &
Pulmonary Other Infective
Anatomy Conduction Heart failure Cyanosis development
hypertension dysmorphology endocarditis
failure
ECG usefulness
A few diagnoses ARE possible on the ECG. Don’t try to work this one out – remember it parrot
fashion (it’s less difficult than it first appears!)
ECG
Diagnoses
Non-
Cardiac
Cardiac
Conduction Anatomy
SA Node: IRBBB,
Massive L-TGA, Baseline
Long PRI: WAP Convex:
RAH, no UVH, tremor in
ARF LAR ischaemia
RV waves PP>SP, limb leads
SVT AOCA
AV Node:
Metabolic:
WPW
K+ Concave:
Other re-
Ca “Peref”
entry
Rx etc
tachy’s
Axis Pink Blue
Purkinje’s: Right/Normal Secundum TAPVD
IRBBB “Primum”= Common QT
CBBB (wide QRS)
Left/Northwest
AVSD atrium QTc = R − R (N ≤ 0.44 in V 5 )
Long QT
Abbreviations: ASD=atrial septal defect; AVSD=atrio-ventricular septal defect; SMA=spinal muscular atrophy; ARF=acute rheumatic fever; peref=pericardial
effusion; IR/CBBB=incomplete t/complete bundle branch block; L-TGA= l-transposition of the great arteries; AOCA=anomalous origin of the coronary artery;
UVH=univentricular heart; PP=pulmonary pressure; SP=systemic pressure; WPW=Wolf-Parkinson-White; WAP=wandering atrial pacemenaker; LAR=low
atrial rhythm; SVT=supraventricular tachycardia; TAPVD=total anomalous pulmonary venous drainage
Chamber Hypertrophy
The others
Right Ventricle
Abbreviations: TA/TS=tricuspid atresia/stenosis; PHT=pulmonary hypertension; PDA=persistent ductus arteriosis; R/LVOFTO=right/left ventricular outflow
tract obstruction; L,RV/AH=left, right ventricular, atrial hypertrophy