ECG Case 024

Asymptomatic adult patient. Routine ECG. Describe the ECG.

TOP 100 ECG QUIZ LITFL 024

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.


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 |

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