Зображення 00761. S2 split by RBBB

Before the age of 3 months this child underwent an operation for a large VSD and PDA. Before the operation pulmonary circulation pressure was about the same as systemic BP, but after the operation it has become normal. The aortic arch is slightly hypoplastic, but no coarctation is seen. ECG shows a wide RBBB that causes a clear split in S2. Phono- and spectrograms show, in addition to the split, also respiratory variation. Registration now performed for the evaluation of RBBB. Age 3.8 years, height 94.0 cm, weight 12 kg. Area of auscultation: left third ic (LIC3).