[Skip to Content]
[Skip to Content Landing]
Article
June 11, 1973

"Lead Thirteen" Electrocardiograph

JAMA. 1973;224(11):1533. doi:10.1001/jama.1973.03220250055028

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

Abstract

To the Editor.—  As sophisticated concepts and techniques in electrocardiography proliferate, there is the danger that significant basic principles may be overlooked. I have encountered many serious instances of misdiagnosis in the interpretation of a Q and inverted T wave in lead III.Figure 1, left, demonstrates lead III (death) in a 39-year-old man whose medical history was totally devoid of cardiac stigmata and continued to be so for a period of more than 11 years. Figure 2, left also represents lead III (death) in a 22-year-old woman without any evidence of cardiovascular disorder. Each case was initially diagnosed elsewhere as having either actual or "possible" inferior myocardial infarction.Repetition of lead III in deep inspiration (Fig 1 and 2, middle) clearly demonstrates the positional origin of the "changes" and, with or without aVf confirmation (Fig 1 and 2, right), provides a means of differentiating important pathological findings from

×