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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