ECG in endocardial cushion defect
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ECG in endocardial cushion defect showing right atrial overload, right upper quadrant axis and right ventricular hypertrophy with strain pattern. Tall P waves in lead II (more than 2.5 mm or 0.25 millivolts) suggest right atrial overload. QRS deflection is negative in leads I and aVF indicating right upper quadrant or north west QRS axis, which could be either extreme right axis or extreme left axis deviation. Tall R waves are seen in V1 and V2 with ST segment depression and asymmetric T wave inversion, indicating right ventricular hypertrophy with strain (systolic overload). Tall R waves in V1 with deep S waves in V6 are a feature of Type I right ventricular hypertrophy (RVH).