Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 25 , ISSUE 2 ( February, 2021 ) > List of Articles

CASE REPORT

Crochetage Sign: An Invaluable Independent ECG Sign in Detecting ASD

Anuj Sarma

Keywords : ASD, Congenital heart disease, Crochetage sign, ECG, ICU, Respiratory distress

Citation Information : Sarma A. Crochetage Sign: An Invaluable Independent ECG Sign in Detecting ASD. Indian J Crit Care Med 2021; 25 (2):234-235.

DOI: 10.5005/jp-journals-10071-23731

License: CC BY-NC 4.0

Published Online: 22-02-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

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.


PDF Share
  1. Heller J, Hagège AA, Besse B, et al. “Crochetage” (notch) on R wave in inferior limb leads: a new independent electrocardiographic sign of atrial septal defect. J Am Coll Cardiol 1996;27(4):877–82. DOI: 10.1016/0735-1097(95)00554-4.
  2. Toscano Barboza E, Brandenburg RO, Swan HJ. Atrial septal defect: the electrocardiogram and its hemodynamic correlation in 100 proved cases. Am J Cardiol 1958;2(6):698–713. DOI: 10.1016/0002-9149(58)90267-4.
  3. Gatzoulis MA, Freeman MA, Siu SC, et al. Atrial arrhythmia after surgical closure of atrial septal defects in adults. N Engl J Med 1999;340(11):839–46. DOI: 10.1056/NEJM199903183401103.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.