JACC. Case reports · 2026
Northwest Axis on Electrocardiogram: Decoding an Unusual Cardiac Axis in a Young Patient.
СтатьяНазвание и аннотация: Перевод в очереди
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González-Najera María Fernanda, Figueroa-Galván Felipe Sebastián, Sáenz-Ordóñez Edgar Alejandro, García-Romero José David, Alanís-Naranjo José Martín, Meave-González Aloha, Cruz-Marmolejo Miguel Ángel
Аннотация
BACKGROUND: We describe a patient with a "northwest" cardiac axis and electrocardiographic features of right ventricular (RV) pressure overload in the setting of Fontan circulation.
TAKE-HOME MESSAGES: In atrioventricular canal defects with Fontan circulation, a northwest cardiac axis on electrocardiography reflects altered RV activation and remodeling, often persisting from childhood into adulthood and secondary to RV outflow tract obstruction.
CASE SUMMARY: A 28-year-old woman presented for routine medical follow-up. Medical history was notable for Fontan procedure, with the last operation performed 12 years earlier, followed by an unspecified percutaneous cardiac intervention. Electrocardiography demonstrated frontal QRS axis between -90° and ±180°, with RV pressure overload. Physical examination revealed a pansystolic murmur audible over the tricuspid and mitral areas, digital clubbing, and an oxygen saturation of 85%. Laboratory evaluation showed a hemoglobin level of 19 g/dL and hematocrit of 62%.
TAKE-HOME MESSAGES: In atrioventricular canal defects with Fontan circulation, a northwest cardiac axis on electrocardiography reflects altered RV activation and remodeling, often persisting from childhood into adulthood and secondary to RV outflow tract obstruction.
CASE SUMMARY: A 28-year-old woman presented for routine medical follow-up. Medical history was notable for Fontan procedure, with the last operation performed 12 years earlier, followed by an unspecified percutaneous cardiac intervention. Electrocardiography demonstrated frontal QRS axis between -90° and ±180°, with RV pressure overload. Physical examination revealed a pansystolic murmur audible over the tricuspid and mitral areas, digital clubbing, and an oxygen saturation of 85%. Laboratory evaluation showed a hemoglobin level of 19 g/dL and hematocrit of 62%.