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Home | ECG Library | Dextrocardia

Dextrocardia

by Dr Chris Nickson, last update July 3, 2019

↪  ECG Library Homepage

ECG Features of Dextrocardia

  • Right axis deviation
  • Positive QRS complexes (with upright P and T waves) in aVR
  • Lead I: inversion of all complexes, aka ‘global negativity’ (inverted P wave, negative QRS, inverted T wave)
  • Absent R-wave progression in the chest leads (dominant S waves throughout)

These changes can be reversed by placing the precordial leads in a mirror-image position on the right side of the chest and reversing the left and right arm leads.

Dextrocardia ECG

Differential Diagnosis

Accidental lead reversal, specifically reversal of the left and right arm electrodes may produce a similar picture to dextrocardia in the limb leads (but with normal appearances in the precordial leads).


See also

  • Top 100 ECG – Case 024
  • Top 100 ECG – Case 025
  • Top 100 ECG – Case 095
  • Eponymictionary –
  • Kartagener syndrome

LITFL Further Reading

  • ECG Library Basics – Waves, Intervals, Segments and Clinical Interpretation
  • ECG A to Z by diagnosis – ECG interpretation in clinical context
  • ECG Exigency and Cardiovascular Curveball – ECG Clinical Cases
  • 100 ECG Quiz – Self-assessment tool for examination practice
  • ECG Reference SITES and BOOKS – the best of the rest

Advanced Reading

  • Brady WJ, Truwit JD. Critical Decisions in Emergency and Acute Care Electrocardiography
  • Surawicz B, Knilans T. Chou’s Electrocardiography in Clinical Practice: Adult and Pediatric
  • Wagner GS. Marriott’s Practical Electrocardiography 12e
  • Chan TC. ECG in Emergency Medicine and Acute Care
  • Rawshani A. Clinical ECG Interpretation
  • Mattu A. ECG’s for the Emergency Physician
  • Hampton JR. The ECG In Practice, 6e

ECG LIBRARY 700

ECG LIBRARY

Electrocardiogram

EKG Library

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About Dr Chris Nickson

An oslerphile emergency physician and intensivist suffering from a bad case of knowledge dipsosis. Key areas of interest include: the ED-ICU interface, toxicology, simulation and the free open-access meducation (FOAM) revolution. @Twitter | INTENSIVE| SMACC

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