Right ventricular strain/hypertrophy with right bundle branch block
New Breathlessness at Age 29
A 29-year-old man has new exertional breathlessness, atypical chest pain, and a heart murmur.
Look for
- Reported right ventricular strain/hypertrophy features.
- Associated right bundle branch block morphology.
Where to look. Compare V1, V5–V6, and the axis in I/aVF; do not conclude from V1 alone.
A dominant R in V1 can accompany RVH but also RBBB. Compare morphology, axis, and other leads; anatomical heart disease requires imaging.
Tetralogy of Fallot is confirmed by echocardiography in the article, not by this ECG alone.
References & provenance
The ECG Made Easy, 9e, ch. 5, PDF 125–128; Lilly, 6e, ch. 4, p. 91–92.
An Adult Patient With a Tetralogy of Fallot Case
Wail Alkashkari; Faisal Al-Husayni; Ahmed Almaqati; Jamilah AlRahimi; Saad Albugami. An Adult Patient With a Tetralogy of Fallot Case. 2020. doi:10.7759/cureus.11658. Figure 1. CC BY 4.0. CC BY 4.0
Adaptation: cropping and removal of headers/annotations outside the tracing where applicable; metadata removed. Waveforms have not been redrawn.
Compared with the published source; no independent clinical validation is claimed.
Original annotations & limitations
HVD/surcharge droite avec BBD
Homme de 29 ans; dyspnée d’effort récente, douleur thoracique atypique et souffle; tétralogie de Fallot confirmée par échographie.
BBD associé: ne pas attribuer toute R dominante en V1 à l’HVD ni faire diagnostiquer la cardiopathie congénitale sur ce seul tracé.