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Challenges in Clinical Electrocardiography
December 2017

Pitfalls of Single-Electrocardiogram Lead Monitoring: A Lead of Deceit

Author Affiliations
  • 1Department of Medicine, University of California-San Francisco, San Francisco
  • 2Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco
  • 3Division of Cardiology, Department of Medicine, San Francisco General Hospital, San Francisco, California
JAMA Intern Med. 2017;177(12):1840-1841. doi:10.1001/jamainternmed.2017.3622

A man in his 30s with no significant medical history was admitted for community-acquired pneumonia. He was prescribed trimethoprim/sulfamethaxazole for treatment of his infection. During his hospital course, he was afebrile, had a regular heart rate of 65 bpm, and a blood pressure of 113/67 mm Hg. His room air oxygen saturation was 98%, and he was breathing comfortably at a rate of 16 breaths per minute. Pulmonary examination revealed bronchial breath sounds, tactile fremitus, and egophony at the right lung base. Cardiac examination was notable for normal central venous pressure and waveforms, a regular cardiac rhythm, nondisplacement of the point of maximal impulse, no precordial lifts, normal first and second heart sounds, and no murmurs, rubs, or gallops. Laboratory test results were all normal.

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