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==Lead reversals== | ==Lead reversals== | ||
Lead switches are a common mistake when ECGs are made and can lead to wrong diagnoses. Common mistakes are: | |||
* left - right arm reversals. This leads to a negative complex in lead I with also a negative P wave in lead I. It is one of the most common causes of right axis deviation on the ECG! | |||
* Arm - foot switches lead to a very small or 'far field' signal in leads II or III. | |||
* Chest lead reversal lead to inappropiate R wave progression (increase - decrease - increase) and are often easily recognized. | |||
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More specific patterns with every lead reversal: | |||
*right leg and right arm: | *right leg and right arm: | ||
**Hardly any signal in lead II. | **Hardly any signal in lead II. | ||
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**inversion of leads I, II and III | **inversion of leads I, II and III | ||
**reversal of leads aVR and aVF | **reversal of leads aVR and aVF | ||
It is possible to distinguish lead reversal and [[w:Dextrocardia|dextrocardia]] by watching the precordial leads. Dextrocardia will not show any R wave progression in leads V1-V6, whereas lead reversal will. | It is possible to distinguish lead reversal and [[w:Dextrocardia|dextrocardia]] by watching the precordial leads. Dextrocardia will not show any R wave progression in leads V1-V6, whereas lead reversal will. |