Guijarro Morales A, Martos Ferrés F, Pagola Vilardebó C, Martín Jiménez V, Martí García J L, Peláez Redondo J
Med Clin (Barc). 1980 May 25;74(10):395-8.
An abnormal ECG suggested the diagnosis of myocardial infarction in a 65-year-old man who had suffered a transient chest pain. When the patient was admitted to the Hospital a new ECG and biochemical enzymes were normal, but and identical pathologic ECG was registered following inversion of the electrocardiographic leads in the right superior and inferior extremities. A prospective study of 160 adult patients has demonstrated that inversion of the leads in the right limbs frequently causes the appearance of pathologic Q waves (37.14 percent) and ischemic T waves (51.22 percent), especially in lead I and aVL. Number of pathologic Q and T waves may vary when they are present in the basal register, but we never observed their disappearance in all the precordial lead series. A constant finding was the marked low voltage of P, QRS and T in lead II due to the "distance" of the electrocardiographic leads right leg-left leg. Technical recognition may be difficult because P waves and QRS complex are frequently negative or isoelectric in aVR.
一名65岁男性出现短暂胸痛，异常心电图提示心肌梗死。患者入院时，新的心电图及生化酶检查均正常，但右上、下肢心电图导联反转后记录到相同的病理性心电图。一项对160例成年患者的前瞻性研究表明，右上肢导联反转常导致病理性Q波（37.14%）和缺血性T波（51.22%）出现，尤其在Ⅰ导联和aVL导联。病理性Q波和T波出现在基础记录中时数量可能不同，但在所有胸前导联系列中我们从未观察到它们消失。一个持续存在的发现是，由于心电图导联右腿-左腿之间的“距离”，Ⅱ导联中P波、QRS波群和T波电压明显降低。由于aVR导联中P波和QRS波群常为负向或等电位，技术识别可能困难。
