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Left P-Wave Axis Deviation: A Clue for Cardiovascular Malformation?
Nicholas Borkey1, Peter Aziz1, Akash Patel1
1Cleveland Clinic Children's, Cleveland, Ohio, USA.
Abstract:
Electrocardiographic finding of left deviation of the p-wave axis is typically associated with a nonsinus atrial focus. Although this is usually a normal variation in children with structurally normal hearts, so-called low atrial rhythm, it may also indicate cardiovascular malformations. CASE: A 12-year-old female was referred for pediatric cardiology evaluation for a murmur. Cardiac auscultation revealed a grade 2/6 vibratory low-frequency systolic ejection murmur at the left sternal border, consistent with a normal Still's murmur. A transthoracic echocardiogram and 15-lead electrocardiogram were obtained.
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