Clinical electrocardiography . Fig. 123.—Electrocardiogram of patient with congenital interventricularseptum defect. Notched Q R S complexes in Derivations I and II. ExaggeratedP wave in Derivations II and III. Right ventricular preponderance. associated defect. If the defect is associated with pulmonic stenosis,the blood is allowed to pass from the right to the left ventricle,relieving the stress of the former and increasing the work of thelatter. In the uncomplicated defect of the septum the stress ofboth ventricles may be equalized and remain so until one or theother begins to fail from som
Clinical electrocardiography . Fig. 123.—Electrocardiogram of patient with congenital interventricularseptum defect. Notched Q R S complexes in Derivations I and II. ExaggeratedP wave in Derivations II and III. Right ventricular preponderance. associated defect. If the defect is associated with pulmonic stenosis,the blood is allowed to pass from the right to the left ventricle,relieving the stress of the former and increasing the work of thelatter. In the uncomplicated defect of the septum the stress ofboth ventricles may be equalized and remain so until one or theother begins to fail from some adventitious cause. It is, therefore,evident that the resulting electrocardiograms may show eitherright or left ventricular preponderance, and in some instancesno imbalance (Fig. 123). 146 CLINICAL ELECTROCARDIOGRAPHY. CONGENITAL HEART DISEASE 147 PATENT DUCTUS ARTERIOSUS (BOTALLI) Patency of the ductus arteriosus is frequently associated withpulmonic stenosis. Any condition during fetal life which inter-fered with the flow of blood through the aorta favors the persistenceof the ductus arteriosus. Hypertrophy of the right ventricle is therule. Figure 124 is the electrocardiogram of a boy having a patentductus arteriosus associated with pulmonic stenosis. Complete
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