Transposition of the great vessels electrocardiogram

Transposition of the great vessels Microchapters
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Dextro-transposition of the great arteries
L-transposition of the great arteries
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Kristin Feeney, B.S. [5]

Overview

There are no specific ECG findings associated with TGA. However, sometimes electrocardiogram may show right axis deviation and right ventricular hypertrophy.

Electrocardiogram

• The ECG may be normal in the newborn, but in older patients signs of right ventricular hypertrophy may be seen.

• Periodic electrocardiograms and/or 24-hour Holter monitoring to monitor for atrial arrhythmias should be employed, particularly following atrial-level switch operation.

• Varying degrees of AV block may be seen in all patients.

• The right axis deviation is moderate or absent, in patients with a large VSD, low pulmonary vascular resistance, and LV volume overload.
• On the other hand, the right axis deviation is greater if there is a reduced pulmonary arterial blood flow and reduced LV volume as a result of pulmonary vascular disease or pulmonic stenosis.

• Q waves are present in right precordial leads which resembles inferior wall myocardial infarction.
• Q waves are absent in left procordial leads.

References

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