‘Crochetage’ sign on ECG in secundum ASD: clinical significance

  title={‘Crochetage’ sign on ECG in secundum ASD: clinical significance},
  author={P. J. Bhattacharyya},
  journal={BMJ Case Reports},
Key MethodA 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…
Atrial septal defect with Crochetage sign presenting with pulmonary artery thrombosis
A 50 years old man who displayed Crochetage sign, incomplete right bundle branch block (IRBBB) and right ventricular strain pattern on ECG illustrates that high suspicion of the ASD with the use of good-old ECG signs remains relevant in this modern era.
The Significance of Crochetage on the R wave of an Electrocardiogram for the Early Diagnosis of Pediatric Secundum Atrial Septal Defect
It is suggested that crochetage on the R wave in inferior limb leads can serve as an independent marker for ASD diagnosis.
A 29-Year-Old Woman with Shortness of Breath and Leg Swelling
  • Medicine
    Cardiology Board Review
  • 2019
'Crochetage' Sign of Atrial Septal Defect.


An electrocardiographic criterion for diagnosis of patent foramen ovale associated with ischemic stroke.
The finding of an ECG crochetage pattern may help to identify stroke patients with PFO, help to streamline their diagnostic workup, and may warrant future studies to determine its value in stratifying stroke risk in patients withPFO.