McGill Case 218

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This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia.

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The right and left arm leads have been reversed in the top tracing. Note the negative P wave in I which suggests that this is not a form of dextrocardia. Note that the precordial leads are unchanged by this error, which also excludes dextrocardia. Note that aVF changes little, aVL switches with aVR, II switches with III.