{"id":29211,"date":"2019-03-30T01:07:17","date_gmt":"2019-03-30T01:07:17","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=29211"},"modified":"2024-02-05T19:32:27","modified_gmt":"2024-02-05T14:02:27","slug":"ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/","title":{"rendered":"ECG Quiz 54 &#8211; Discussion: Right arm &#8211;  Left leg lead reversal"},"content":{"rendered":"<h2><span style=\"color: #008000;\">ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal<\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-29212\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/03\/ECG54A.jpg\" alt=\"\" width=\"1902\" height=\"889\" \/><\/p>\n<p style=\"text-align: center;\"><strong><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/03\/ECG54A.jpg\">Click here for a larger image<\/a><\/strong><\/p>\n<p>Lead I shows inverted P waves, which in the absence of features of dextrocardia in the chest leads, that is, regression of amplitude of QRS complexes as you move from V1-V6, should make one suspect lead reversal. But this is not the common right arm &#8211; left arm lead reversal pattern when you look at the inferior leads. At one look, the inferior leads makes you think of an evolved inferior wall myocardial infarction. But the clue is the inverted P waves in inferior leads. Uniform negativity of the QRS complex and T waves along with P waves makes one suspect a misplaced left leg electrode. When the left leg electrode is placed on the right arm and vice versa, the P wave, QRS and T waves which usually have downward vectors, get inverted. In fact such an ECG is usually misdiagnosed as inferior wall infarction unless one is careful to go in a sequential manner starting from the P wave as is usually taught in ECG lessons.<\/p>\n<p><a href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54\/\"><strong>Back to ECG Quiz 54<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal Click here for a larger image Lead I shows inverted P waves, which in the absence of features of dextrocardia in the chest leads, that is, regression of amplitude of QRS complexes as you move from V1-V6, should make one suspect lead reversal. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":29212,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[],"class_list":["post-29211","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECG Quiz 54 - Discussion: Right arm - Left leg lead reversal - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECG Quiz 54 - Discussion: Right arm - Left leg lead reversal - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal Click here for a larger image Lead I shows inverted P waves, which in the absence of features of dextrocardia in the chest leads, that is, regression of amplitude of QRS complexes as you move from V1-V6, should make one suspect lead reversal. [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2019-03-30T01:07:17+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-02-05T14:02:27+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal\",\"datePublished\":\"2019-03-30T01:07:17+00:00\",\"dateModified\":\"2024-02-05T14:02:27+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/\"},\"wordCount\":201,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"ECG \\\/ Electrophysiology\",\"ECG Library\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/\",\"name\":\"ECG Quiz 54 - Discussion: Right arm - Left leg lead reversal - All About Cardiovascular System and Disorders\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2019-03-30T01:07:17+00:00\",\"dateModified\":\"2024-02-05T14:02:27+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ECG Quiz 54 - Discussion: Right arm - Left leg lead reversal - All About Cardiovascular System and Disorders","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/","og_locale":"en_US","og_type":"article","og_title":"ECG Quiz 54 - Discussion: Right arm - Left leg lead reversal - All About Cardiovascular System and Disorders","og_description":"ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal Click here for a larger image Lead I shows inverted P waves, which in the absence of features of dextrocardia in the chest leads, that is, regression of amplitude of QRS complexes as you move from V1-V6, should make one suspect lead reversal. [&hellip;]","og_url":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2019-03-30T01:07:17+00:00","article_modified_time":"2024-02-05T14:02:27+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal","datePublished":"2019-03-30T01:07:17+00:00","dateModified":"2024-02-05T14:02:27+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/"},"wordCount":201,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#primaryimage"},"thumbnailUrl":"","articleSection":["ECG \/ Electrophysiology","ECG Library"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/","url":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/","name":"ECG Quiz 54 - Discussion: Right arm - Left leg lead reversal - All About Cardiovascular System and Disorders","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#primaryimage"},"thumbnailUrl":"","datePublished":"2019-03-30T01:07:17+00:00","dateModified":"2024-02-05T14:02:27+00:00","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-54-discussion-right-arm-left-leg-lead-reversal\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"ECG Quiz 54 &#8211; Discussion: Right arm &#8211; Left leg lead reversal"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/29211","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=29211"}],"version-history":[{"count":3,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/29211\/revisions"}],"predecessor-version":[{"id":62574,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/29211\/revisions\/62574"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=29211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=29211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=29211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}