Electrocardiogram of a 41 year-old woman with congenital heart disease admitted to hospital with right sided hemiparesis.

Rate 77/min
PR 0.21 sec
QRS 0.10 sec
QT 0.43 sec
QTc 0.48 sec
QRS axis +95º

Interpretation: Abnormal ECG. Sinus rhythm, one PVC, one PAC. First degree AV block. Bi-atrial abnormality. Right axis deviation. Left ventricular hypertrophy. Non-specific repolarization abnormalities.

The patient has tetralogy of Fallot, pulmonary atresia, underwent right Blalock-Taussig shunt at the age of 8 but no complete correction of tetralogy. Developed Eisenmenger’s syndrome. Right sided hemiparesis was a consequence of brain abscess requiring drainage and prolonged antibiotic therapy.

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