Sarma Anuj
Department of Anaesthesia and Critical Care Medicine, Down Town Hospital, Guwahati, India.
Indian J Crit Care Med. 2021 Feb;25(2):234-235. doi: 10.5005/jp-journals-10071-23731.
Bedside diagnosis of congenital heart disease is sometimes very difficult in patient presenting with respiratory distress in intensive care unit. However, an ECG can provide abundant information regarding its presence and its management. A 25-year-old female presented with sudden onset of respiratory difficulty and shortness of breath, following delivery one day back. Echocardiography could not be done as a poor echo window was obtained and patient could not lie down supine. However, ECG revealed right axis deviation, RBBB, and notching in the apex of the R wave in inferior leads 2,3,aVF (crochetage sign). This is directed to the presence of ASD, which was confirmed with echocardiography after stabilization of patient. We would like to illustrate the importance of simple bedside ECG finding of crochetage sign in the diagnosis of ASD when echocardiography is not possible or available in underdeveloped countries. Sarma A. Crochetage Sign: An Invaluable Independent ECG Sign in Detecting ASD. Indian J Crit Care Med 2021;25(2):234-235.
在重症监护病房中，对于出现呼吸窘迫的患者，先天性心脏病的床旁诊断有时非常困难。然而，心电图可以提供有关其存在及处理的丰富信息。一名25岁女性在产后一天突然出现呼吸困难和气促。由于获得的超声心动图窗不佳且患者无法仰卧，故未能进行超声心动图检查。然而，心电图显示电轴右偏、右束支传导阻滞以及下壁导联Ⅱ、Ⅲ、aVF中R波顶点切迹（钩编征）。这提示存在房间隔缺损，患者病情稳定后经超声心动图证实。我们想说明，在不发达国家无法进行超声心动图检查时，床旁心电图简单的钩编征表现对房间隔缺损诊断的重要性。萨尔马A。钩编征：检测房间隔缺损时一项宝贵的独立心电图征象。《印度重症医学杂志》2021年；25(2):234 - 235。
