ECG 12 đạo trình và điện tâm đồ trực giao (X, Y, Z, tương tự như tôi, VF và V2) của một bệnh nhân 65 tuổi với một bệnh phổi tắc nghẽn mãn tính (COPD). Lưu ý sự hiện diện của một AQRS rightward (90 ◦), một mô hình qr V1 với một mô hình RS V6 là dấu hiệu của phì đại tâm thất phải | 138 Self-assessment Answer to Case 9 Comment. The 12-lead ECG and the orthogonal ECG X Y z similar to I VF and V2 of a 65-year-old patient with a chronic obstructive pulmonary disease COED . Note the presence of a rightward ÂQRS 90 a qr pattern in VI with an rS pattern in V6 as signs of right ventricular enlargement RVE . The rightward AP whh peaked Fwaves in leads II III and VF with relatively high voltage if it is to be compared with the QRS complex is a sign suggestive of a right atrial enlargement RAE . The p wave is negative in VI as is frequently the case in COPD as given that the AP is in quite a vertical position its projection on the horizontal plane HP is minimal and additionally it can fall into the negativehemifieldof lead VI. Note the similarity between orthogonal leads X and V2 in the surface ECG. These signs are not compatible with a normal variant. On the other hand T-wave morphology from VI to V4 canbeexplainea bytheright chamber overload produced by the COPE and drt byavteroser idl éschadmiodueOd aoerutecoronary complete right Onndtetwaneh dloeOelecttocQdiographic sions faund a one of reoonds andtOg hl moryholoaa diniidie waoe inVt tSat could betxplaineO at iht RVOpi vt n whentts origints ndrtly Outtoaielaym thesttmhlusgavCnctiee wlthiotno rlnhtdentricla tRV . dhoerfgre thecorreci cnswon iiA tsoc p. etandc-411. Self-assessment 139 Case 10 This is a non-cyanotic newborn with a systolic 5 6 murmur in the second left intercostal space. Which is the correct diagnosis A Ventricular septal defect B Significant pulmonary stenosis c Atrial septal defect D Mitral regurgitation 140 Self-assessment Answer to Case 10 Comment. The correct diagnosis is a significant pulmonary stenosis in a newborn. Note the qR morphology with a positive T wave in VI and an RS complex with a positive T wave in V6 typical of a significant RVE in the newborn p. 40 . The ECGcorresponds to a pure RVE as seen in the cases with a severe .
