ECG of the Week - 15th October 2018 - Interpretation

This ECG is from a 45 yr old female who presented after an episode of chest pain. She has no past medical history and takes no regular medications. She has a positive family history of cardiac disease.

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Rate:

• 60 bpm

Rhythm:

• Sinus arrhythmia

Axis:

• Extreme axis deviation

Intervals:

• PR - Normal 
• QRS - Normal (100ms)

Additional:

• Partial RBBB
• U waves inferior leads
• T wave inversion leads I & aVF 
• Note P and QRS inversion
• Flat T waves leads V2 & V3

Interpretation:

• Lead reversal LA / RA
• Results in:
• Inversion lead I
• Swap aVL & aVR
• Swap lead II & III

References / Further Reading

Life in the Fast Lane

• Lead Reversal 

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.