Gepubliceerd in:
01-08-2012 | Rhythm Puzzle - Answer
Right side or left side: an inconspicuous masquerade
Gepubliceerd in: Netherlands Heart Journal | Uitgave 7-8/2012
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Careful examination of the ECG in Fig. 1 shows inverted P waves in leads I, aVL and V2 to V6. Also notice the upright P waves in aVR and absence of R wave progression in the precordial leads. These are classic findings in dextrocardia. Hence the important physical examination finding in this patient would be better audibility of heart sounds on the right side of the precordium. Limb lead reversal causing ‘technical dextrocardia’ is a close differential diagnosis, but can be ruled out here as it would not explain the inverted P waves seen in V2 to V6.[1]
Fig. 1
Standard 12-lead ECG
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