The medial precordial leads: overburdened and underinvestigated.
Leads V1, V2 and sometimes V3 are omnibus leads that are "overburdened" because they monitor the left ventricular anterior wall, the left ventricular posterior wall, and the right ventricle; because they are the only leads normally expressing the ventricular gradient (QRS-T discordance); and because they consequently reflect numerous anatomic and electrical abnormalities and apparently normal variants. These require familiarity with and differentiation among a variety of pathologic and normal conditions.
Spodick
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DH
Cardiology Division, St. Vincent Hospital, Worcester, Massachusetts 01604, USA.
Bishop
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RL
D004562:Electrocardiography; D006331:Heart Diseases / Q000175:diagnosis; D006801:Humans; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right