What is the dx?
Digitize using #PMCardio
What is your ECG rhythm interpretation?
B Ectopic atrial rhythm
C.SR, old lateral wall MI
D Wrong lead placement
Answer: This is lead misplacement (RA/LA reversal).
This indeed looked dextrocardia - I is reversed/ aVR looked like aVL.
However, the Rwave progression looked normal from L>R (increasing Rwave from V1>V6). So, this is a big blue that this is lead misplacement.
In RA and LA reversal, the following are noted:
• Lead I is reversed.
• Lead II becomes lead III and vice versa.
• Lead aVR become lead aVL and vice versa.
• Lead aVF is unchanged.
A repeat ECG is shown.
Here is a link for sample cases of dextrocardia.