Dextrocardia with RBBB

Report:

Sinus rhythm

Mirror-image dextrocardia

Right bundle branch block

Nonspecific ST/T changes

Comment:

The precordial sequence gives the diagnosis. In the (much commoner) situation of technical arms’ lead reversal153, the V leads are unaffected.

Below (Fig 217a) is the ECG with all leads reversed, unfortunately (for looking at the P waves) with an atrial pacemaker. Even so, the capturing sinus P wave (first in the ECG) stands upright in lead 1.

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