Related Experiment Video

Updated: Oct 26, 2025

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

3.9K

Atrial septal defect with Crochetage sign presenting with pulmonary artery thrombosis

Neerusha Kaisbain1, Wei Juan Lim2,3, Heng Shee Kim4

  • 1Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia.

BMJ Case Reports
|July 28, 2021
PubMed

Insights

This study highlights how specific electrocardiogram (ECG) signs, like the Crochetage sign and incomplete right bundle branch block (IRBBB), can aid in diagnosing atrial septal defect (ASD) in adults. Early ECG recognition of ASD is crucial, especially for preventing complications like pulmonary thrombosis in patients with Eisenmenger syndrome.

Area of Science:

  • Cardiology
  • Medical Diagnostics

Background:

  • Atrial septal defect (ASD) is a common congenital heart defect in adults.
  • Electrocardiography (ECG) offers several sensitive findings for ASD diagnosis.

Observation:

  • A 50-year-old male presented with Crochetage sign, incomplete right bundle branch block (IRBBB), and right ventricular strain on ECG.
  • The Crochetage sign is highly specific for ASD and correlates with shunt severity.
  • Combined Crochetage sign and IRBBB patterns increase diagnostic specificity for ASD.

Findings:

  • The patient was diagnosed with a large (3 cm) ASD with a bidirectional shunt.
  • Pulmonary thrombosis was identified concurrently with the large ASD.
  • ECG findings, including Crochetage sign and IRBBB, were crucial for diagnosis.

Implications:

  • High clinical suspicion for ASD, supported by traditional ECG signs, remains vital in contemporary medicine.
  • Patients with Eisenmenger syndrome face an elevated risk of pulmonary thrombosis.
  • Accurate ECG interpretation is essential to differentiate signs like Crochetage from IRBBB abnormalities.

Keywords:
arrhythmiascardiovascular medicinevalvar diseasesvenous thromboembolism

More Related Videos

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

3.7K
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation07:28

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation

Published on: October 11, 2024

508

Related Concept Videos

Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
96
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
50
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
93
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
125
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
76
Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
200