Indicative vs Reciprocal ECG Interpretation
Views of the heart
Views seen on a 12-Lead ECG that look directly at a surface of the heart are referred to as “indicative leads” i.e. the views provided on a standard (left side of the chest) ECG like II, III, aVF – inferior etc.
If additional views are required to view the right ventricle or posterior of the heart directly, the chest leads would actually have to be physically moved to either the right side or posterior wall of the chest.
This is not always practical or prudent in the emergency setting…so, many providers initially rely upon indirect (reciprocal) views.
Views of the heart that or indirect are often referred to as “mirror-image” or “reverse” or “reciprocal” views.
In this instance morphologic changes that we would typically expect to see would be the reverse or opposite change. Meaning, what we would expect to see elevated would be depressed and changes reflected in depression would be elevated.
What is up would be down and down would be up!
Authors and Sources
Authors and Reviewers
- ECG heart rhythm modules: Thomas O'Brien.
- ECG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language ECG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
- Last Update: 11/8/2021
Electrocardiography for Healthcare Professionals, 5th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
- Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH