Key result
ECG crochetage sign reveals a 38 mm ASD in an asymptomatic adult, prompting successful surgical closure.
Why the study?
Atrial septal defect is a common congenital heart disease that often remains asymptomatic until adulthood.
The crochetage sign on an ECG is a subtle yet clinically significant indicator of an atrial septal defect that warrants further assessment, even in asymptomatic individuals.
Alerts to occult ASD on routine ECG; leaves open prospective validation of crochetage sign utility.
Atrial septal defect (ASD) is a common congenital heart disease that often remains asymptomatic until adulthood. We present the case of a young construction worker in his early twenties who was rescued following a tunnel collapse and was incidentally found to have a large ostium secundum ASD during routine medical evaluation. A crochetage sign—a notch at the apex of the R wave in the inferior electrocardiogram leads—prompted further assessment. Transthoracic echocardiography confirmed a 38 mm ASD with right atrial and right ventricular dilatation, along with moderate tricuspid regurgitation. The patient subsequently underwent successful surgical closure of the defect, with an uneventful postoperative course. This case highlights the crochetage sign as a subtle yet clinically significant electrocardiographic indicator of ASD, warranting consideration even in asymptomatic individuals.
No takes yet. Share an insight, caveat, or question.
Sharma et al. (2024) studied this question. The crochetage sign on ECG indicated a large 38 mm atrial septal defect in an asymptomatic young adult, aiding diagnosis and prompting successful surgical closure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: