- HPI: 60M with chest pain
- Key ECG: Whenever you see a bizarre ECG, look at leads I, II, and III. See if one of them does NOT look bizarre. In this case, lead I does not look bizarre, but all other leads do. Since lead I looks relatively normal, that means that the right arm and left arm electrodes must be OK. It is the left leg electrode that is abnormal. The amplitude of the artifact from a single extremity source, is maximal in the unipolar augmented electrode of the “culprit” extremity. The amplitude of the artifact in the other 2 augmented leds (ie, leads aVR and aVL) — is about 1/2 the amplitude of the artifact in lead aVF.
- Link to full case @ Dr. Smith’s ECG Blog: 2023-01-17