Lead Placement Error

Case 29: A 42-Year-Old Female in the Gynecology Ward

Practice Level 4

Case 29: A 42-Year-Old Female in the Gynecology Ward History Diagnosis ECG 2 ECG 2 Diagnosis History A 42-year-old woman is admitted to the gynecology ward pre-operatively. An ECG is performed, which shows the following abnormality: Diagnosis Lead error: left arm electrode/cable detached/non-functional. This precludes the interpretation of the limb leads Sinus rhythm with sinus arrythmia …

Case 29: A 42-Year-Old Female in the Gynecology Ward Read More »

alt

Case 44: A 73-Year-Old Man Presenting for Follow-Up

Practice Level 4

Case 44: A 73-Year-Old Man Presenting for Follow-Up History Diagnosis ECG 2 ECG 2 Diagnosis Diagram History This 73-year-old man with known dilated cardiomyopathy is in the cardiac clinic for a routine reassessment: Diagnosis Suspect lead placement error: left arm-right leg lead reversal Sinus rhythm 60/min, with one premature atrial complex Possible non-specific intraventricular block …

Case 44: A 73-Year-Old Man Presenting for Follow-Up Read More »

Case 60: An 82-Year-Old Man in the Cardiac Surgical ICU

Practice Level 4

Case 60: An 82-Year-Old Man in the Cardiac Surgical ICU History Diagnosis History An 82-year-old man is in the cardiac surgical ICU, one day after a triple aorto-coronary bypass: Diagnosis Sinus rhythm, 97/min Bifascicular block – Right bundle branch block and left posterior fascicular block ST and T wave abnormality, consider inferior ischemia ST abnormality, …

Case 60: An 82-Year-Old Man in the Cardiac Surgical ICU Read More »

Case 66: A 57-Year-Old Man in the Cardiac Surgical Unit

Practice Level 4

Case 66: A 57-Year-Old Man in the Cardiac Surgical Unit History Diagnosis ECG 2 ECG 2 Diagnosis History This 57-year-old diabetic man was admitted with a non-ST-elevation MI, and found to have significant lesions of the main-left and circumflex coronary arteries: Diagnosis Chest leads placement error (V1-V5 reversal) Sinus rhythm Low T wave voltage in …

Case 66: A 57-Year-Old Man in the Cardiac Surgical Unit Read More »

Case 99: A 57-Year-Old Woman in the Emergency Department

Practice Level 4

Case 99: A 57-Year-Old Woman in the Emergency Department History Diagnosis ECG 2 ECG 2 Diagnosis Explanation History A 57-year-old woman presents to the emergency department with community acquired pneumonia: Diagnosis Lead error – right arm-right leg lead reversal  ECG 2 After correcting the lead placement, the following ECG was recorded: ECG 2 Diagnosis The …

Case 99: A 57-Year-Old Woman in the Emergency Department Read More »

Case 113: A 47-Year-Old Man in the Cardiac Catheterization Lab

Practice Level 4

Case 113: A 47-Year-Old Man in the Cardiac Catheterization Lab History Diagnosis ECG 2 ECG 2 Diagnosis History A 47-year-old man presenting with severe chest pain for the past hour is transferred to the catheterization lab for coronary angiography: Diagnosis Right arm – Left arm reversal Sinus rhythm Septal myocardial infarction, age undetermined T wave …

Case 113: A 47-Year-Old Man in the Cardiac Catheterization Lab Read More »