A Misleading Preoperative Electrocardiogram

Chihjen Lee; Christian Seif

doi:10.20944/preprints202208.0453.v1

Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 24 August 2022 / Approved: 26 August 2022 / Online: 26 August 2022 (09:27:06 CEST)

A 57-year-old male with a history of hyperlipidemia and mild pulmonary hypertension presented for a left inguinal hernia repair. Preoperative electrocardiogram showed severe right axis deviation at 177 degrees and abnormal repolarization. Right ventricular hypertrophy secondary to pulmonary hypertension was the primary differential but was quickly ruled out due to the patient being asymptomatic and having great exercise tolerance. Dextrocardia was also ruled out due to normal progression on the precordial leads. The simultaneous severe right axis deviations of P, R, and T waves raised suspicion for erroneous lead placement. The repeat electrocardiogram confirmed the diagnosis.

electrocardiogram; pulmonary hypertension; right axis deviation; dextrocardia; technical errors

Medicine and Pharmacology, Anesthesiology and Pain Medicine

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A Misleading Preoperative Electrocardiogram

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