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Pediatría (Asunción)

versão On-line ISSN 1683-9803


SUH, Dong Chin et al. Clinical and electrocardiographic findings in pediatric patients with atrial septal defects. Pediatr. (Asunción) [online]. 2019, vol.46, n.3, pp.179-184. ISSN 1683-9803.


Atrial Septal Defect (ASD) is a frequent congenital heart disease, the diagnosis of which is difficult in paucisymptomatic patients. Without treatment, it can lead to heart failure, arrhythmias and pulmonary hypertension. The electrocardiogram may provide evidence of this condition.


To describe the clinical and electrocardiographic findings of patients with ASD.

Materials and Methods:

This was a retrospective study of patients under age 18 who underwent cardiac evaluation from January 2008 to December 2013. The electrocardiographic and clinical finding variables suggestive of ASD are described.


There were 77 patients with ASD. The most frequent reasons for consultation among patients with ASD were heart murmur, Down syndrome and dyspnea. Findings on physical examination of patients with ASD were: systolic murmur in 69% and S2 split in 56%. On the electrocardiogram, the patients had QRS of 79 ms, electric axis deviated to the right, Incomplete Right Bundle Branch and notch pattern. The most frequent right ventricular volume overload (RVVO) criteria were the deep S wave in V6 and the high R wave in V1. Auscultation of a split S2 on the physical examination, as well as the RVVO and the notch pattern were the most frequent findings in patients with ASD.


the electrocardiogram is a valid tool in the evaluation of patients with suspected ASD but requires the combination of clinical findings to reach the diagnosis.

Palavras-chave : Atrial septal defect; electrocardiogram; incomplete right bundle branch block; notch.

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