(1)
Pediatric Cardiology, Policlinico S.Orsola-Malpighi, Bologna, Italy
Fig. 13.1
(a) Fourteen-year-old boy with incidental finding of abnormal right precordial leads and PVCs. (b) Polymorphic PVCs with LBBB morphology (arising from RV). MRI and US found signs of ARVC. (c) the patient had a syncopal episode soon after the diagnosis of ARVC and was implanted with an ICD. After 3 months the device discharged a sustained VT
Fig. 13.2
(a) Thirteen-year-old male with ARVC . The abnormal T wave in right precordial leads can be noted. The low voltage in the limb leads is also suggestive of ARVC. (b) Epsilon wave (arrow)
Fig. 13.3
(a) Fifteen-year-old male with ARVC . Fast VT as a first manifestation of the disease, (b) baseline ECG, (c) epsilon wave in V1
Fig. 13.4
(a) Thirteen-year-old male with ARVC with left ventricular extension. Diffuse low voltages, pathologic Q waves (inferior leads), and ST–T changes, PVCs can be noticed. (b) The MRI showed severe biventricular fibrosis
Fig. 13.5
(a) Fifteen-year-old girl with HCM associated with ventricular preexcitation . The S–T T changes are secondary to both conditions. (b) Close-up. The last beat (arrow) is different in both depolarization and repolarization, compatible with a fusion beat (PVC) or conduction trough a second accessory pathway. (c) Sixteen-year-old girl with massive septal HCM. The pseudodelta QRS slurring can be noticed
Fig. 13.6
(a) DCM in a 9-year-old female. (b, c) Close-up. Note the diffuse ST–T changes
Fig. 13.7
(a) DCM secondary to anthracycline therapy for lymphoma. Once again, limb leads low voltages and ST–T changes are suggestive of CMP. (b, c) Close-up. The atrial enlargement indicates high filling pressure
Fig. 13.8
Left ventricular non compaction cardiomyopathy (LVNC) . (a) Two-year-old male: note the atrial enlargement and ST–T changes. (b) Thirteen-year-old female: note the QRS enlargement for intraventricular conduction delay (incomplete LBBB). (c) Twenty-two-year-old male with trisomy 13. Note the ST–T changes
Fig. 13.9
(a) Ten-year-old male with restrictive CMP . (b) close-up, note the atrial enlargement. (c) Restrictive CMP in a 14 year old male. Note the massive biatrial enlargement; in some leads the P wave is bigger than the R wave
Fig. 13.10
(a) Eleven-year-old male with HCM . (b) Close-up. Huge Q waves in the inferior leads can be noted
Fig. 13.11
HCM in two young 20-year-old women. (a) On echo the ventricular septum is 30 mm thick. The voltages are not as can be expected in a massive hypertrophy like this. There is the arrow sign in the precordial leads (R wave decreasing from V2 to V6. (b) Massive hypertrophy on echo but the voltages in limb leads are poor. The MRI showed severe fibrosis, one of the reasons which explain the discrepancy between thickness and ECG voltages
Fig. 13.12
(a) Twelve-year-old male with HCM and restrictive physiology. The systolic function is intact, but the patient showed diastolic heart failure. The atrial enlargement can be noted. (b) Fifteen-year-old male with restrictive neuropathic HCM . (c) Close-up. A long PR and incomplete LBBB can be noticed
