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Pediatric ECGInterpretation

An Illustrative Guide

B.J. Deal MD

C.L. Johnsrude MD

S.H. Buck MD

Blackwell

Futura

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Figure 2: 2-week-old infant

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Figure 3: 5-month-old female

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Figure 4: Asymptomatic 1-year-old male

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Figure 5: Asymptomatic 5-year-old female

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Figure 6: Asymptomatic 8-year-old female

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Figure 7: Healthy 15-year-old male

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Figure 8: 8-year-old boy referred for irregular heart rhythm

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Figure 9: Asymptomatic 14-year-old female

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Figure 11: 9-year-old boy referred for murmur evaluation

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Figure 12: 5-day-old infant, being calmed during ECG acquisition

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Figure 14: 16-year-old girl with tricuspid atresia status post Fontan procedure

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Figure 15: 4-week-old infant with transposition of the great arteries,

ventricular septal defect, status post arterial switch operation

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Figure 16: 9-year-old boy with loud systolic murmur at left upper sternal border

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Figure 17: 7-month-old infant with loud systolic murmur at left upper sternal border

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Figure 19: 5-year-old girl with systolic murmur at right upper sternal border

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Figure 21: Neonate with critical aortic stenosis

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Figure 22: 1-year-old female with ventricular septal defect

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Figure 25: 7-year-old girl evaluated for recurrent syncope

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Figure 26: 1-year-old boy with hypotonia

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Figure 27: 8-year-old boy with muscular dystrophy

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Figure 29: 13-year-old girl with familial periodic paralysis

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Figure 30: Young adult with renal failure, marked hyperkalemia (K = 7.4 mEq/L)+

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Figure 31: 17-year-old male with renal failure

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Figure 32: 10-year-old boy with autoimmune collagen vascular disease,presents with chest pain

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Figure 34: 2-year-old boy with severe pulmonary hypertension

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Figure 35: 17-year-old male status post heart transplantation

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Figure 37: 3-year-old girl referred with systolic murmur at left upper sternal borderand fixed splitting of second heart sound

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Figure 38: 3-year-old boy with murmur and cardiomegaly

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Figure 39: 2-month-old infant with murmur, poor weight gain

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Figure 40: 2-month-old infant with Down syndrome, murmur, cardiomegaly,

failure to thrive

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Figure 41: 8-year-old girl with continuous murmur in infraclavicular area,

mild cardiomegaly

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Figure 43: Neonate with severe cyanosis

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Figure 44: 3-week-old infant with marked cyanosis

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Figure 45: 2-day-old infant with cyanosis

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Figure 46: 1-week-old male with tachypnea and mild cyanosis

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Figure 47: 1-month-old infant with tachypnea, murmur, cardiomegaly

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Figure 48: 1-day-old infant with tachypnea, poor femoral pulses, cardiomegaly

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Figure 49: 6-month-old infant with loud systolic murmur at

right upper sternal border

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Figure 50: 8-month-old infant with harsh systolic murmur at

left upper sternal border

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Figure 51: 4-month-old infant with wheezing and cardiomegaly

(ECG courtesy of Richard Friedman, M.D.)

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Figure 52: 2-year-old boy with murmur, mild cardiomegaly,frequent episodes of supraventricular tachycardia

(ECG courtesy of Scott Buck, M.D.)

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Figure 53: 5-day-old infant with dextrocardia

(ECG courtesy of Richard Friedman, M.D.)

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Figure 54: 16-year-old male athlete

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Figure 55: 16-year-old female receiving sotalol for supraventricular tachycardia

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Figure 56: 21-year-old male with transposition of the great arteries,status post Mustard repair

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Figure 57: 9-year-old girl status post Fontan procedure for tricuspid atresia

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Figure 58: 2-year-old girl referred for irregular heart rhythm

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Figure 59: 6-year-old boy referred for irregular heart rhythm

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Figure 60: 6-year-old boy referred for irregular heart rhythm

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Figure 61: 9-year-old boy with arthralgia and recent sore throat

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Figure 62: 8-year-old boy with slow heart rate

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Figure 63: 10-year-old boy with resolving myocarditis

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Figure 64: 8-year-old girl with congenital complete heart block

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Figure 65: 15-year-old girl with syncope during phlebotomy

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Figure 66: 13-year-old boy status post repair of ventricular septal defect

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Figure 67: 13-year-old boy with hypertrophic cardiomyopathy

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Figure 68: 10-year-old boy with fever, tachypnea, malaise

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Figure 70: 3-month-old infant with fever

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Figure 71: 2-week-old infant with cyanosis and irregular heart rhythm

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Figure 72: 22-year-old male referred for evaluation of palpitations

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Figure 73: 11-year-old boy with palpitations

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Figure 74: 9-year-old boy with palpitations

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Figure 75: 6-year-old boy with frequent episodes of supraventricular tachycardia

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Figure 76: 12-year-old boy with syncope during a baseball game

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Figure 77: 6-day-old infant with tachycardia, irritability

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Figure 79: 3-year-old infant with tachycardia, history ofWolff-Parkinson-White syndrome, receiving digoxin

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Figure 80: ECG during sinus rhythm of patient (at 2 weeks of age)seen on preceding tracing

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Figure 81: 13-year-old male with lightheadedness during exertion

(ECG courtesy of J. Patel, M.D.)

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Figure 82: ECG during sinus rhythm of patient seen on preceding tracing

(ECG courtesy of J. Patel, M.D.)

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Figure 83: 8-year-old girl with brief episodes of tachycardia,terminated with Valsalva maneuver

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Figure 84: 1-month-old infant with incessant tachycardianoted during well-child examination

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Figure 85: 1-day-old infant with tachycardia in utero

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Figure 86: 4-week-old infant status post arterial switch operationfor transposition of the great arteries

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Figure 87: 10-year-old girl status post Fontan procedure for tricuspid atresia,in emergency room for headache and fatigue

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Figure 88: 14-year-old boy status post Fontan procedure for complex single ventricle;complaining of fatigue

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Figure 89: 4-month-old infant with congestive heart failure;

tachycardia rate slowed by anti-arrhythmic medications

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Figure 90: 10-year-old girl with nausea and fatigue, cardiomegaly

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Figure 91: 2-week-old infant with tachycardia

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Figure 93: 16-year-old girl with palpitations, status post Fontan procedure

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Figure 94: 3-year-old boy with irregular rhythm

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Figure 95: 1-week-old infant with irregular heart rhythm

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Figure 96: 8-year-old girl evaluated for chest pain

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Figure 98: 11-year-old boy with exertional tachycardia

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Figure 99: 10-year-old boy with 3-day history of fever, vomiting, malaise

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Figure 100: 1-year-old boy with fever, hemodynamic collapse

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Figure 101: 6-year-old boy 6 hours post-intracardiac repair of aortic stenosis;tachycardia responded to removal of mediastinal chest tube

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Figure 102: 8-year-old boy status post repair of double outlet right ventricle;syncope with exertion

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Figure 103: 4-year-old boy with recurrent tachycardia status postrepair of double outlet right ventricle

(ECG courtesy of Ernerio Alboliras, M.D.)

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Figure 105: 30-year-old male with strong family history of sudden death(ECG courtesy of David Ruschhaupt, M.D.)

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Figure 106: 12-year- old girl with exertional syncope; history of seizures

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Figure 107: 10-year-old boy with syncope

(ECG courtesy of Michael Ackerman, M.D.)

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Figure 108: 10-year-old boy with syncope, same patient as prior ECG

(ECG courtesy of Michael Ackerman, M.D.)

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Figure 109: 19-year-old male with near-drowning episode

(ECG courtesy of Michael Ackerman, M.D.)

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Figure 110: Neonate with bradycardia and seizures

(ECG courtesy of John Hokanson, M.D.)

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Figure 111: Holter: 7-year- old boy with seizure disorder

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Figure 112: Holter: 7-year- old boy with seizure disorder

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Figure 114: 1-year-old boy with congenital complete heart block,ventricular pacemaker

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Figure 115: 16-year-old girl with dual-chamber pacemaker for complete heart block

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Figure 116: 13-year-old female with dual-chamber pacemaker

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Figure 117: 18-year-old male, status post Mustard procedure fortransposition of the great arteries, with atrial pacemaker

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Figure 118: 18-year-old male, status post Mustard procedure fortransposition of the great arteries, with atrial pacemaker

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