High V1/V2 misplacement

It is very common to place the first two chest electrodes too high. If this has happened, the QRS complex may have developed ‘evil bunny ears’ that can be easily mistaken for an incomplete right bundle branch block. The T waves in these leads may also become inverted and mimic a heart attack. This will all go back to normal if the ECG is repeated with the V1 and V2 electrodes in the 4th intercostal space.

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In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead High V1/V2 misplacement Dr Smith's ECG Blog CC BY-NC
Chest Pain and Q-waves in V1 and V2. Is there previous septal MI? 27725

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 12-Lead High V1/V2 misplacement Inferior ST elevation Reciprocal ST depression Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
A 50-something woman with chest pain and 2 “normal” ECGs at triage 27481

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 12-Lead High V1/V2 misplacement Hyperacute T waves Late R wave transition Terminal QRS distortion Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic 26016

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 12-Lead High V1/V2 misplacement Serial 12-lead Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 2 – En route to cath center 26560

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 12-Lead High V1/V2 misplacement Serial 12-lead Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 3 – En route to cath center 26563

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 12-Lead High V1/V2 misplacement Serial 12-lead Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 4 – En route to cath center 26566

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: - 12-Lead High V1/V2 misplacement Serial 12-lead Normal Axis Normal P waves Normal T waves Normal Sinus Rhythm Normal Dr Smith's ECG Blog CC BY-NC
A pathognomonic ECG you should recognize instantly. Baseline ECG 26602

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: - 12-Lead High V1/V2 misplacement Inverted P waves RSR' Atrial Rhythms Normal ST elevation Dr Smith's ECG Blog CC BY-NC
Are these Wellens’ waves? 18482

This ECG is from a man in his 20s who presented with nausea and vomiting after drinking the night before.  He denied any chest pain or shortness of breath. The computer interpretation was "Acute STEMI".

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement LVH ECG Interpretation CC-BY-NC-SA
ECG Blog #127 (Acute STEMI – Lead Malposition – LVH – Reciprocal Changes) 6497