The ECG is a useful tool that can help in the diagnosis of some congenital cardiopathies, even though it is secondary to echocardiography for the correct pathology definition. On the other hand, ECG is of primary importance for the diagnosis of arrhythmic disorders in paediatric patients as well as in the adult ones.
The first ECG of this chapter belongs to a patient affected by a corrected transposition of the great vessels. The ECG presents typical characteristics that contribute to the diagnosis: inversion of the normal precordial pattern with Q waves in right precordial leads, QS or QRS pattern in inferior leads, left axis deviation and positive T waves in all precordial leads. Similarly, in the third case, the ECG presents an element that can lead to the diagnosis of atrioventricular canal. Leftward-superior QRS axis deviation and incomplete right bundle branch block association are strongly suggestive.
The second and fourth ECGs are both cases of tachycardias, with narrow and large QRS complexes, respectively: in these cases the ECG is essential for the differential diagnosis.
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