Electrocardiogram #4


Five year old boy with Pulmonary Valve Stenosis (PVS)


Right Ventricular Hypertrophy (Deep S in V6, upright T in V1, right axis deviation)

Right Atrial Enlargement (Very tall p waves in leads 2, AVF, V1 – V6)

There is obstruction to blood flow out of the right ventricle at the level of the pulmonary valve. This causes the right ventricle to work harder to push blood into the pulmonary artery. As a consequence the right ventricular muscle hypertrophies. As the right ventricle squeezes there is usually back flow through the tricuspid valve into the right atrium and this will cause right atrial enlargement