Think Beyond Right Bundle Branch Block in Atrial Septal Defect
نویسندگان
چکیده
475 The Editor, A 48‐year‐old woman presented with shortness of breath on routine activities for 6 months. On cardiac auscultation, an ejection systolic murmur was heard at the upper left sternal border with wide and fixed splitting of the second heart sound. Electrocardiogram (ECG) was suggestive of normal sinus rhythm with right‐axis deviation, incomplete right bundle branch block (RBBB), and crochetage sign (notch near the apex of R‐wave) [Figure 1]. Transthoracic echocardiography was performed which revealed large ostium secundum atrial septal defect (ASD) of size 28 mm with large left‐to‐right shunt (Qp: Qs – 2.2:1) [Figure 2]. Coronary angiography of the patient was normal. The patient underwent cardiac surgery, and ASD was closed using the Dacron patch. No residual shunt across interatrial septum was observed after the surgery. Postoperative ECG showed disappearance of crochetage pattern [Figure 3].
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