Dextrocardia electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Claudia Hochberg, M.D.; Assistant Editor-In-Chief: Kristin Feeney, B.S. [[5]]
Overview
Electrocardiogram may be used as a diagnostic tool in the evaluation of an atrial septal defect. ECG findings associated with dextrocardia include an R wave inversion.
Electrocardiogram
It is possible to distinguish lead reversal and dextrocardia by watching the precordial leads. Dextrocardia will show an R wave inversion, whereas lead reversal will not.
The bottom EKG shows marked right axis deviation and loss of voltage across the precordium. There are also inverted P waves in leads I and aVL. The differential for inverted P waves in lead I and aVL is Dextrocardia vs Reversed Arm Leads. Since there is loss of voltage across the precordium this is Dextrocardia.
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Right and left arm lead reversal can be distinguished from the (much rarer) dextrocardia by looking at the precordial R wave progression.
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EKG in a patient with dextrocardia. This EKG shows marked right axis deviation and loss of voltage across the precordium. There are also inverted p waves in leads I and aVL. The differential for inverted p waves in lead I and aVL is Dextrocardia or Reversed Arm Leads. Since there is loss of voltage across the precordium this is Dextrocardia.
