UMEM Educational Pearls

Category: Pediatrics

Title: Pediatric ECG

Posted: 9/9/2011 by Rose Chasm, MD (Updated: 6/15/2024)
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  • newborns have a thick right ventricle resulting in a mean QRS axis which points anteriorly and to the right demonstrating a right axis deviation (70-180degress) and large R waves in the precordium
  • by 3 months of age, the QRS axis in the frontal plane shifts to the left with a mean of 65degress (0-125degress)
  • by older childhood, the normal mean QRS axis is -30-100degress)
  • thus, with age the R wave decreases in V1 and increases in V6
  • take home:  right-axis deviation is often a normal finding in children and young adults when you see left-axis deviation in children consider tricuspid atresia, atrioventricular septal defects, and LVH as the most associated conditions

References

MedStudy Pedatrics Board Review, Core Curriculum, Book 3 2004