---is the voltage paradox. High in the precordial leads, low in the limb leads. I’ve seen this paradox several times. Expecting to find a hypertrophic cardiomyopathy, I have repeatedly ended up surprised when the echo reveals dilated cardiomyopathy. Imagine my ah-ha moment when I read this case report from the Baylor University Medical Center Proceedings! Those interested in a quantitative treatment of the relationship between the voltages in the precordial and limb leads as a predictor of DCM should check out this paper.
Related: LBBB + RAD as a predictor of DCM.