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Patient
34-year-old man with ankylosing spondylitis;
Trace
Sinus rhythm; pattern of diastolic ventricular hypertrophy with narrow q waves in leads I, aVL, V3-V6, increase in R wave amplitude in V5, V6, increase in S wave amplitude in V1, V2, positive T waves in left precordial leads; ultrasound showed significant aortic insufficiency with moderate left ventricular hypertrophy;
Patient
63-year-old woman with rheumatoid arthritis in childhood, not followed since; hospitalization for cardiac decompensation;
Trace
Sinus rhythm; major systolic left ventricular hypertrophy (very significant increase in voltages: R waves in V4-V6, S waves in V1-V2); biatrial enlargement; repolarization disorders (negative T waves in leads I, aVL, II, III, AVF, V4-V6); cardiac ultrasound revealed a very severe aortic insufficiency with dilatation of the cavity and major left ventricular hypertrophy;
Exergue
Left ventricular hypertrophy that is initially diastolic and subsequently mixed (systolic and diastolic) is the electrical sign characteristic of chronic aortic insufficiency.
Aortic insufficiency is caused by incomplete closure of the aortic valves, resulting in left intraventricular diastolic regurgitation (reflux of blood from the aorta to the left ventricle during diastole).