ECG Basics and Fundamentals: limb lead reversal

ECG Weekly Workout with Dr. Amal Mattu


A 82-year-old woman presents to the ED “not feeling well”. She reports malaise, mild dyspnea, but denies any pain. Vital signs are normal. The following ECG is obtained on arrival with no prior ECGs available for comparison:

Before watching the video, look closely at this ECG and ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the rhythm and axis?
  3. What is your differential diagnosis and most likely cause?