The Electrocardiogram of the Neonate

There are many methods of assessing newborn infants suspected of having congenital heart disease and one of the earliest methodologies, and still a very important investigation, is the performance of a scalar electrocardiogram. Over the years, the correlation between abnormal physiology and gross pathology has been developed so that there are now signs in the electrocardiogram (ECG) that are characteristic of certain types of malformation. There are various ways of displaying the electrical activity in the heart on the surface of the chest, but the most convenient and most familiar is the scalar ECG. The analysis of the ECG can give us accurate information about abnormalities in heart rhythm, show us signs indicating local or general ischemia and indicate enlargement or hypertrophy of heart chambers leading to conclusions about the underlying pathology. The analysis of the ECG in the newborn is more complicated than in the older child because there are various stresses that occur during the birth process that can affect the ECG. These are added to the changes in the ECG due to a specific malformation.