LAUSR

A 29-year-old male presented to the cardiology department with a 2-day history of aggravating choking sensation in the chest and symptoms of heart failure. He had a history of congenital heart disease diagnosed at 2 years of age. Physical examination revealed orthopnea, cyanosis, apical impulse located on the right side of his chest, and hepatic dullness located in the left subcostal region. A 12-lead ECG is shown in Figure 1. The ECG was inconsistent with typical ECG characteristics of mirror-image dextrocardia because R wave progression occurred in leads V1 through V6, although the R wave amplitude decreased progressively. How should we analyze ECG combined with clinical findings to confirm our diagnosis? Figure 1. Standard 12-lead ECG on admission. The 12-lead ECG on admission showed an inverted P wave in leads I and aVL (downward arrows), and the electric axis of the heart was −75°. The QRS complexes …