Letter by Patel et al Regarding Article, “Masking Inferior Infarction by Anterior Myocardial Injury”
To the Editor:
The recent article by Deng and Das,1 “Masking Inferior Infarction by Anterior Myocardial Injury,” was interesting. In our opinion, however, the findings represent lead reversal, with the left-arm and left-leg leads misapplied.2 The result is that in Figure 2 of the original article, lead I looks like lead II, lead II looks like lead I, and lead III is the mirror image of Figure 1. When the leads are correctly placed during the third ECG (Figure 3 of the original article), the inferior-wall infarction reappeared.
For years, we have emphasized to our students, residents, and fellows the importance of recognizing lead reversal, because infarcts may be simulated or missed.