Arm lead reversal vs Dextrocardia in ecg

Reversal of arm leads is the commonest error when recording an ecg/ekg.

Negative P in lead 1 is an useful diagnostic clue.

Chest leads show normal transition with tall R in lead reversal , whereas in true mirror-image dextrocardia the QRS complex becomes smaller and displays mostly QS or rS in v4-v6.

Also as we know lead 1 v5 v6 show same polarity a they are all lateral leads.If lead 1 qrs predominantly negative while v5,6 is positive, suspect reversal.

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