Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Ventricular septal defect electrocardiogram
Introduction
Electrocardiogram
Electrocardiogram
The ECG changes reflect the size of shunt and degree of pulmonary hypertension
Small VSD
- Restrictive VSD, Qρ/Qѕ < 1.5/1.0 Qρ/Qs is pressure gradient between pulmonary and systemic circulation: EKG is normal. A few patients will have an rsr’ in V1.
Medium-sized VSD
- left atrial overload – broad notched P wave
- Left ventricular overload – Deep ‘Q’ wave, tall ‘R’ wave, tall ‘T’ wave in lead V5 and V6
- Atrial fibrillation can also be seen
Large VSD
- In adults or adolescence with a large VSD and pulmonary vascular obstructive disease, LVH is absent because volume overload of the LV is no longer present. Large VSD will produce right ventricular hypertrophy with right axis deviation. At this point there is either an rsR’ pattern in the right precordial leads, or more commonly, a tall monophasic R wave in the right precordial leads reflecting RVH. Also deep S waves in the lateral precordial leads and tall peaked P waves.
In patients with an acquired infundibular stenosis, the EKG shows a pattern of RVH similar to the tracing of patients with tetralogy of Fallot.
References
References
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Keri Shafer, M.D. [2]; Atif Mohammad, M.D., Priyamvada Singh, MBBS