Case 18: A 56-Year-Old Woman in Cardiac Catheterization Lab
History
Diagnosis
ECG 2
ECG 2 Diagnosis
Comparing ECG 1 vs. ECG 2
History
A 56-year-old woman with recent onset of angina is in the cardiac catheterization lab for coronary angiography:
Diagnosis
The P wave and the QRS are negative in I and aVL, positive in aVR (that’s the reverse of what occurs normally) The chest leads are OK, which rules out dextrocardia.
The most likely diagnosis is: Lead error, Right Arm – Left Arm Reversal
Another ECG should be recorded, with special attention to correct placement of the lead cables!
ECG 2
This is a repeat ECG, recorded 20 minutes later:
ECG 2 Diagnosis
This tracing is normal. The previous ECG had been incorrectly recorded. (right arm – left arm reversal)
Comparing ECG 1 vs. ECG 2
ECG ID: E399