ecg: situs inversus atrialis
Post on 11-Aug-2015
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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
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