A 37-year-old man is in the Emergency Department with localized anterior chest pain made worse by palpation of the chest wall:

• Lead placement error: Right Arm – Right leg reversal (this precludes the interpretation of the limb leads)                  

    The chest leads are normal
    The computer ECG program had incorrectly diagnosed “lateral myocardial infarction”

As lead misplacement is suspected, a new ECG is recorded, with particular attention to correct cable placement:

• Sinus rhythm, 60/min
• Normal ECG

  Please, see next slide. (explanatory slide)

                     Please, see the TUTORIAL on  LEAD ERRORS for an animated illustration of the RIGHT ARM – RIGHT LEG REVERSAL