High V1/V2 misplacement

V1 and V2 electrodes should be placed in the 4th intercostal space, either side of the sternum. All too often this space is not accurately located. If you spot that the QRS complex in V1 has developed ‘evil bunny ears’ (rSr’), check the electrode placement – there are other causes but high electrode misplacement is all too common. Other signs include negative P and T waves in V2, or a larger negative component to a biphasic P wave in V1 and V2.

See also: Electrode misplacement

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In the ECGquest archives, this ECG has been tagged with: - High V1/V2 misplacement RSR' Saddleback ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Saddleback ST Elevation. Is it STEMI? Is it type II Brugada?

This ECG is from a man in his 50s who presented with epigastric and chest pain.

This ECG shows saddleback ST elevation, but a RSR pattern in V1 that suggested lead misplacement. When the electrodes were repositioned there was no evidence of ischemia.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement 12-Lead Dr Smith's ECG Blog CC BY-NC
Chest Pain and Q-waves in V1 and V2. Is there previous septal MI?

This ECG is from a middle aged woman who presented with chest pain.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Inferior ST elevation Reciprocal ST depression Acute Inferior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer Dr Stephen W. Smith CC BY-NC
A 50-something woman with chest pain and 2 “normal” ECGs at triage

This ECG is from a woman in her 50s who presented with one hour of chest tightness on a background of diabetes and hypertension.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 4 – En route to cath center

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This ECG was recorded en route to the hospital.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Hyperacute T waves Late R wave transition Terminal QRS distortion Acute Anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This was her first prehospital ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 2 – En route to cath center

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This was her second ECG en route to the hospital.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 3 – En route to cath center

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This ECG was recorded en route to the hospital.

In the ECGquest archives, this ECG has been tagged with: - High V1/V2 misplacement Normal Axis Normal P waves Normal T waves Normal Sinus Rhythm Normal 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A pathognomonic ECG you should recognize instantly. Baseline ECG

This ECG is from a patient of unknown age who presented with generalised weakness and malaise. This was the baseline ECG from a previous presentation.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement LVH ECG Interpretation Dr Ken Grauer CC-BY-NC-SA
ECG Blog #127 (Acute STEMI – Lead Malposition – LVH – Reciprocal Changes)