Congenital Heart Disease Tachycardia VSD 
All About Cardiovascular System and Disorders
FEBRUARY 14, 2024
The sign has been described in VSD with biventricular hypertrophy in children. It can be seen with isolated VSD as well as complex ventricular septal defect. Katz-Wachtel Phenomenon or Sign on ECG in VSD An ECG with Katz-Wachtel phenomenon is shown here.
All About Cardiovascular System and Disorders
MARCH 20, 2024
But in a VSD with pulmonary hypertension A wave is not prominent. So a prominent A wave in a complex congenital heart disease situation would indicate that interventricular septum is intact. It will not occur in the presence of a large VSD which equalizes both right ventricular and left ventricular pressures.
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