All issues > Volume 32(8); 1989

Original Article

J Korean Pediatr Soc. 1989;32(8):1098-1105. Published online August 31, 1989.

The Hemodynamics and Electrocardiogram in Isolated Ventricular Septal Defect.

Kwang Man Kim¹, Ki Young Song¹, Sang Kwon Lee¹, Tae Chan Kwon¹, Chin Moo Kang¹

¹Department of Pediatrics, Keimyung University, School of Medicine，Taegu, Korea

Received: December 30, 1988;  Accepted: March 3, 1989.

Abstract

Ventricular septal defect is the most common cardiac malformation, accounting for 25% of congenital heart disease. The electrocardiogram is becoming more useful as a tool in estimating the size of the ventricular septal defect and the type of pulmonary vascular response. This report comprises 210 patients in whom the diagnosis of isolated ventricular septal defect was made by cardiac catheterization and angiocardiography at Dong San Hospital, Keimyung University during the period of 5 years and 6 months from Jan. 1982 to June 1987. Following results were obtained. Out of 210 patients, 128 were male and 82 were female. Their ages ranged from 4 months to 15 years. Ventricular septal defect was classified according to Kirklin classification. The most common type was type II (79%) followed by type I (18.6%). The QRS axis were as follows in orders: normal axis (70.7%), right axis deviation (19.4%), and left axis deviation (9.9%). The large diphasic QRS complex in precordial lead V、was encountered in 43.1% of the cases. When the R : S ratio in V\ was more than upper limit of normal, the right ventricular systolic pressure was significantly higher than that of the R : S ratio less than lower limit of normal (p<0. 001). When the R : S ratio in V6 was less than lower limit of normal, the right ventricular systolic pressure was significantly higher than that of the R : S ratio more than upper limit of normal (p<0. 001). When a normal electrocardiographic pattern was present, the right ventricular systolic pressure was normal. When left ventricular hypertrophy pattern was present, the right ventricular systolic pressure was moderately increased, but biventricular and right ventricular hypertrophy was present, the right ventricular systolic pressure was markedly increased. Between electrocardiographic pattern and right ventricular systolic pressure was statistically significant (p< 0.001).

Keywords :Electrocardiogram, Ventricular Septal Defect