Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ ECG Findings ++ Rightward axis. Positive QRS complex in aVR. Inversion of the entire complex in lead I. Loss of R wave progression. QRS deflections in V4 to V6 are small and downgoing. +++ Pearls ++ The orientation of the heart in the chest cavity is reversed with the predominant electrical activity moving left to right (as opposed to right to left). Normally placed precordial leads in a patient with dextrocardia are actually placed over the thinner right ventricle instead of the left ventricle. Reversing all ECG leads should produce an essentially normal ECG. A “reversed” lead I (“downward” QRS) and “reversed” lead aVR (“upward” QRS) with normal-appearing V leads strongly suggests limb lead reversal. ++ FIGURE 23.37A Dextrocardia. (ECG contributor: James V. Ritchie, MD.) Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ FIGURE 23.37B The P wave, QRS, and T wave are downgoing in lead I. Differential diagnosis includes limb lead reversal and dextrocardia. The 12-lead ECG above represents dextrocardia as evidenced in the abnormal precordial leads. Graphic Jump LocationView Full Size||Download Slide (.ppt) Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.