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.
Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |
MBBS DDU (Emergency) CCPU. Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Co-creator of the LITFL ECG Library. Twitter: @rob_buttner