The following ECG is from a 70 year old female who was referred by her GP following an episode of chest pain.
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- PR – Normal (~160ms)
- QRS – Normal (100ms)
- Flat lead II – near isoelectric
- Complete reversal leads III, aVF
- T inversion
- Negative QRS
- Negative P waves – low voltage
- Prominent T wave lead V2
- ST depression leads V5-6
- Multiple abnormalities in limb leads
- Secondary to complex lead reversal – not typical of paired lead swap
- Prominent T wave in lead V2 with ST depression in lateral leads
What happened ? A repeat ECG with correct lead position resulted in resolution of all limb lead abnormalities and unchanged non-dynamic precordial lead changes.Serial cardiac biomarkers were negative and the patient was discharge.
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
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