Özet:

Bifascicular block is defined as left bundle branch block or right bundle branch block associated either with a left anterior or left posterior fascicular block. It can be due to congenital or acquired heart disease. Electrocardiography for preparation before dental extraction therapy under general anesthesia in a 4-year-old girl showed superior QRS axis, right bundle branch block and left anterior hemiblock. Echocardiographic examination revealed complete atrioventricular septal defect that prevented interventricular transition by bridging leaflets. Angiography showed minimal left to right shunt via the primum ASD. Clinical follow-up was decided on as the patient was hemodynamically stable. Primum atrial septal defect can be diagnosed before the development of pulmonary vascular disease by careful assessment of the ECG in asymptomatic patients

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