Congenital Heart Disease Tricuspid 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. Himalayan P waves are also described in tricuspid atresia.
All About Cardiovascular System and Disorders
MARCH 20, 2024
And that will be the approximate level of the tricuspid valve, the reference point for measuring right atrial pressure. In right atrial tracing, this occurs at the time of right ventricular contraction, with bulging upwards of the tricuspid valve. The Y descent is shallow in tricuspid stenosis, and absent in cardiac tamponade.
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