Maladie pulmonaire

Le diagnostic doit être suggéré devant une association d’anomalies qui incluent un rabottage de r en précordiales jusqu’en V6 avec transition tardive et S plutôt profondes en V5V6.

The pattern includes (Surawicz AHA 2009, lifeinthefastlane) :

1. Rightward shift of the QRS axis towards +90 degrees (vertical axis or beyond) superior or indeterminate (Surawick 2009).

2. Clockwise rotation of the heart with delayed R/S transition point in the precordial leads +/- persistent S wave in V6. There may be complete absence of R waves in leads V1-V3 (the “SV1-SV2-SV3” pattern).

3. Sometimes associated :

– prominent P (peaked) waves in the inferior leads with rightward shift of the P wave axis and flattened or inverted P waves in leads I and aVL ;

– exaggerated atrial depolarisation causing PR and ST segments that “sag” below the TP baseline ;

– low voltage QRS complexes, especially in the limb leads and left precordial leads (V4-6).

– ventriculuar hypertrophy

– RBBB

Ref. http://lifeinthefastlane.com/ecg-library/copd); RBBB or RVH