Case 52: A 76-Year-Old Woman Admitted with Congestive Heart Failure
History
Diagnosis
ECG 2
ECG 2 Diagnosis
ECG 3
ECG 3 Diagnosis
Explanatory Diagram
History
A 76-year-old woman is admitted to the cardiac ward for treatment of heart failure:
Diagnosis
- Sinus bradycardia, 55/min
- Right bundle branch block
- Anterior myocardial infarction, age undetermined
ECG 2
The patient is improving with treatment. An ECG is recorded 2 days after admission: 
ECG 2 Diagnosis
- The changes in the limb leads are due to a lead placement error: Right arm-right leg lead reversal
The precordial leads are unchanged:
- Right bundle branch block
- Anterior myocardial infarction, age undetermined
ECG 3
A repeat ECG is obtained a few hours later:
ECG 3 Diagnosis
The previous ECG had been incorrectly recorded (Right arm-Right leg lead reversal)
Compared with the admission tracing (ECG 1) no significant change
- Sinus rhythm
- Right bundle branch block
- Anterior myocardial infarction
Explanatory Diagram
ECG ID: E437