A routine pre-operative ECG is performed on a woman in her fifties. She is asymptomatic, but she tells you that she has previously been seen by the cardiologists. You are asked to review the ECG. Click on the ECG to see a bigger version.
- Describe the ECG
- What do you think is the diagnosis?
- What one test would you like to perform to support your conclusions?
Many thanks to Dr Marc Dweck for this case. Students, let us know what you think on the discussion board.
Show the answer
Thanks to all of our students who joined in this discussion. Many of our students correctly identified the key abnormalities in this ECG (superior and rightward axis, with poor progression of R waves across the chest leads) and concluded that the diagnosis in this case was dextrocardia. The one investigation that would have confirmed the diagnosis was a simple chest X-ray, though an echocardiogram would also have done the job.
This case was adapted with permission from one of the cases available at the Edinburgh Cardiovascular Imaging Website. This is a fantastic new and open resource set up by the Edinburgh Heart Centre and the Clinical Research Imaging Centre. We would strongly recommend a visit to this site to see other cases and images that are available.