TY - JOUR T1 - ‘Crochetage’ sign on ECG in secundum ASD: clinical significance JF - BMJ Case Reports DO - 10.1136/bcr-2016-217817 VL - 2016 SP - bcr2016217817 AU - Pranab Jyoti Bhattacharyya Y1 - 2016/10/10 UR - http://casereports.bmj.com/content/2016/bcr-2016-217817.abstract N2 - A 50-year-old woman with no cardiovascular risk factors was evaluated for easy fatigability and progressive dyspnoea on exertion for the last 1 year. Cardiac auscultation revealed a normal first heart sound, an ejection systolic murmur at the upper left sternal border and wide and fixed splitting of the second heart sound. The ECG demonstrated sinus rhythm, incomplete right bundle branch block (RBBB) and ‘crochetage’ sign (notch near the apex of the R wave) in inferior limb leads (figure 1). There was evidence of cardiomegaly, dilated main pulmonary artery … ER -