ECG OF THE WEEK

DR.VIKRAMAN.G,P.G.

PROF.S.SUNDAR UNIT

• A 55 year old male patient with complaints of chest pain right sided associated with sweating, palpitation not radiating for the past 10 hours.

• ECG findings;• P wave-inverted in I,avL and upright in avR.• PR interval-0.22sec• QRS complex-QS in I,II,III,avF,avL,V5,V6 R wave in avR RS in V1 diminution of R waves from v1-6 • ST segment- ST↑II>III,V4-6,I, ST↓ avR,V1

DIAGNOSIS

• Situs inversus atrialis with l-looping of the ventricles-Dextrocardia

• Acute IPWMI with RVMI (morphological RV)-Prox.RCA territory infarct

• Sinus Bradycardia/First degree AV block

confirmed by various serial ECGs

Limb and chest leads in opposite sides

V3RV3R

V4R

V5R

V6R

Limb leads reversed

• ST depression with R waves in V1,V3R,suggests posterior wall MI (mirror image of AWMI)

• ST segment Depression in V2<V1 In a dextrocardia with IPWMI suggests RVMI.

THANK U