Available online 6 September 2022
Highlights•In tetralogy of Fallot the ECG findings reflect right ventricular remodeling.
•A frontal QRS axis between −90° and ±180 (northwest axis) is a rare ECG finding.
•QRS duration ≥150 ms and northwest axis associate with an enlarged right ventricle in tetralogy of Fallot.
AbstractThe typical ECG changes in tetralogy of Fallot are right axis deviation, large R waves in the anterior precordial leads and large S waves in the lateral precordial leads. We present a patient with extreme deviation of the frontal QRS axis between −90° and ± 180°. The child underwent open heart surgery twice before one year of age and a third time at nine years of age. The axis change persisted into adulthood.
KeywordsTetralogy of Fallot
QRS axis
Northwest axis
© 2022 The Authors. Published by Elsevier Inc.
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