Correspondence

Dextrocardia with Situs Inversus

N Engl J Med 2005; 353:2515December 8, 2005

Article

To the Editor:

We question the electrocardiographic findings in the case of dextrocardia presented by Yin and Mohamed in Images in Clinical Medicine (Sept. 1 issue).1 We agree that the reverse R-wave progression across the precordial leads, with the tallest R wave in V₁ progressively decreasing in amplitude in leads V₂ to V₆, as shown in Panel B of the original image, is typical of dextrocardia. We also agree that a normal pattern is evident in the precordial leads on right-sided electrocardiography (Panel C of the original image). However, the electrical waves should not change in the limb leads unless the placement of the electrodes was changed (Figure 1Figure 1Electrocardiogram from a Typical Patient with Dextrocardia.).

Pablo Aguiar-Souto, M.D.
Lorenzo Silva-Melchor, M.D.
Francisco J. Ortigosa-Aso, M.D.
Puerta de Hierro Hospital, 28035 Madrid, Spain
aguiarsouto@hotmail.com

1 References

1
Yin LK, Mohamed AL. Dextrocardia with situs inversus. N Engl J Med 2005;353:933-933
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Author/Editor Response

Concerning the questions raised by Dr. Aguiar-Souto and colleagues about the electrical waves shown in Panel C of our image, it is true that the limb leads were changed for the purpose of comparison. This point should have been highlighted in the text.

Loh Keng Yin, M.Med.
International Medical University Malaysia, 70300 Seremban, Malaysia