ECG showing<unk>  In general, a positive (upwards) deflection of an ECG trace demonstrates an electrical activity that moves towards the measuring electrode, whereas a negative (downwards) deflection of an ECG trace demonstrates an electrical activity that moves away from the measuring electrode. The electrical heart<unk>  can be estimated from the ECG by using the quadrant method or degree method. # Quadrant Method: Leads I and II are usually observed. If lead I is positive (translating to 0° on the hexaxial reference system) and lead II is positive (translating to 60°), the electrical heart<unk>  is estimated to fall in the left lower quadrant within the normal range. On the other hand, as shown in Figure 2, if lead I is negative (translating to 180°) and lead II is positive, the electrical heart<unk>  is estimated to fall in the<unk>  lower quadrant suggesting a<unk> . Similarly, leads I and aVF can be used. # Degree method: First, identify the lead with the smallest QRS complex or isoelectric (flat) QRS complex (lead a). After locating the<unk>  of the lead on the hexaxial reference system, identify the lead which is perpendicular to it (lead b). If lead b is positive, the electrical heart<unk>  can be estimated to lie within the quadrant between<unk>  of lead a and lead b. A simple tool to quickly identify<unk><unk>  (Figure 3) is the popular mnemonic; Reaching for<unk>  and Leaving for Left<unk><unk> . This refers to the appearance of leads I and III. If the QRS complex is negative in lead I and positive in lead III, the QRS complexes appear to be "reaching" to touch each other. This signifies<unk> . Conversely, if the QRS complex is positive in lead I and negative in lead III. the leads have the appearance of "leaving" each other. If the QRS complex in lead II is also negative, this confirms a left<unk><unk> .
Right axis deviation
Pulsus alternans
Dichotic pitch
Heart click
Shifting dullness
Apex beat
Precordial thump
Third heart sound