This Can Be as Easy as 1-2-3

• Published in: JACC. Case reports Vol. 3; no. 11; pp. 1382 - 1383
• Main Authors: Sanghvi, Saagar K., Vidovich, Mladen I.
• Format: Journal Article
• Language: English
• Published: Elsevier 01-09-2021
• Subjects: Ecg Teaching Competition
• ISSN: 2666-0849; 2666-0849
• DOI: 10.1016/j.jaccas.2021.06.036

The S1S2S3 pattern, in conjunction with right-dominant forces on a 12-lead electrocardiogram including a tall R-wave in lead V
1
(R:S >1), deep S waves in the left precordial leads V
5
and V
6
(R:S <1), QRS interval <120 ms, and right atrial enlargement (P-wave in lead II >2.5 mm), is highly specific for right ventricular dysfunction with pulmonary hypertension. (
Level of Difficulty: Intermediate.
)