ECG Case 024
Asymptomatic adult patient. Routine ECG. Describe the ECG.
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
Main Abnormalities
This ECG demonstrates the typical features of dextrocardia:
- Marked right axis deviation (+180 degrees)
- Lead aVR: Positive QRS complex (upright P and T waves)
- Lead I: inversion of all complexes, aka ‘global negativity’ (inverted P-QRS-T)
- Absent R-wave progression in the chest leads (dominant S waves throughout)
Differential Diagnosis
Accidental 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.
References
Further Reading
- Wiesbauer F, Kühn P. ECG Mastery: Yellow Belt online course. Understand ECG basics. Medmastery
- Wiesbauer F, Kühn P. ECG Mastery: Blue Belt online course: Become an ECG expert. Medmastery
- Kühn P, Houghton A. ECG Mastery: Black Belt Workshop. Advanced ECG interpretation. Medmastery
- Rawshani A. Clinical ECG Interpretation ECG Waves
- Smith SW. Dr Smith’s ECG blog.
- Wiesbauer F. Little Black Book of ECG Secrets. Medmastery PDF
TOP 100 ECG Series
Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |
MBBS FACEM DDU (Emergency) CCPU. Emergency Physician in Melbourne, Australia. Co-Ultrasound Lead for Emergency Medicine at The Alfred Hospital. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor of the LITFL ECG Library.