Key result
Malpositioning of precordial electrodes 3 cm too low masked pathological ST segment elevation and negative T waves, resulting in a seemingly normal ECG.
Why the study?
Does precordial electrode misplacement mask pathological ECG findings?
Case Report (n=1)
Does precordial electrode misplacement mask pathological ECG findings?
Incorrect placement of precordial electrodes can mask significant pathological ECG findings such as ST elevation, potentially leading to life-threatening consequences.
May obscure ST elevation on ECGs; single case leaves open prevalence and prevention strategies.
We report the case of a 57-year-old woman found at home who received an ECG after having recovered from a seizure, without any clinical cardiac anomaly. The ECG revealed an elevation of the ST segment from the V1 to V5 leads and negative T waves from V1 to V5 leads. At her hospital admission, the emergency care unit (ECU) nurse performed another ECG. It no longer showed any repolarisation anomaly. However, the ECU nurse had put the precordial electrodes 3 cm too low, probably due to the patient's voluminous breasts. In the end, the pathological trace reappeared after we returned the electrodes to their initial positions. Malpositioning of the electrodes caused a seemingly normal ECG result with life-threatening consequences.
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Derkenne et al. (2017) conducted a case report in ECG electrode misplacement (n=1). ECG electrode misplacement vs. Correct electrode placement was evaluated on ECG trace appearance. Malpositioning of precordial electrodes 3 cm too low masked pathological ST segment elevation and negative T waves, resulting in a seemingly normal ECG.
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