The Electrocardiographic and Vectorcardiographic Findings of Tetralogy of Fallot

The electrocadiographic and vectorcardiographic findings were reviewed in 49 cases of tetralogy of Fallot, confirmed by cardiac catheterization and angiocardiographic findings and/or, by surgery. In most cases, the electrocardiographic findings were right axis deviation and right ventricular hypertrophy. Vectorcardiographic findings were as following; 1) The initial vector directed to anterior and slightly left or right. 2) The maximum vector directed to right, anterior or posterior and inferior. 3) The terminalvector directed to right, posterior and inferior. 4) The loop inscription of horizontal plane and frontal plane were mainly clockwise. Five cases out of 49 showed somewhat atypical electrocardiographic findimgs. In 2 cases, rS pattern all through the chest leads were observed and in another 2, right chest leads showed the RS pattern(predominantly S) and left chest leads showed the not tall R waves and in the remaining 1, left axis deviation was noticed. The vectorcardiogram of these 5 cases showed the less Rx and Qz, larger Sx and Rz. In horizontal plane, main area is shifted to the third quadrant and direction of the maximum vector is right, posterior and inferior, and the inscription of loop is counterclockwise or figure of 8. The vectorcardiographic findings of tetralogy of Fallot which showed rS pattern were not different from those of single ventricle which showed rS pattern all through the precordial leads. Counterclockqwise or figure of 8 herizontal inscription is known to suggest mild tetralogy of Fallot but counterclocwise or figure of 8 inscription with small Rz and Qz may suggest severe tetralogy of Fallot.

Malignant Choroid Plexus Tumor in an Infant

A 42 day-old male infant visited to our emergency room with chief complaints of convulsion. Prenatal and birth histories were unremarkable. The patient appeared well except persistent jaundice and had no signs of increased intracranial pressure. The head circumference at birth was not measured. The head circumference at 42 days was 39cm(50th percnntile) At the age of 42 days, tonic convulsion developed suddenly and soon fell into coma. The patient died, 20 hours after arrival. Postmortem examiation revealed a large necrotic tumor mass in the left lateral ventricle of the cerebral hemispheres. The tumor growths were histologically composed of partly papillary but most undifferentiated carcinoma arising from the choroid plexus of the left lateral ventricle. In addition to celluar anaplasia many mitoses were observed. The tumor masses invaded periventricular while matter and also extended to subarachnoid space of the cerebral and cerebellar hemispheres. The central part of the tumor was undergoing necrosis and massive hemorrhage which extended into surrounding brain parenchyme.