Incorrectly aligned fly leads inside the ECG machine causing 'ischaemic' changes.
We describe a case in which a young woman was inappropriately diagnosed as having ischaemic heart disease after presenting with exertional neck pain and an abnormal ECG. Diffuse Q-wave and T-wave inversion changes were later attributed to erroneous placement of fly leads inside the ECG machine at a recent service. Clinicians should be aware of this uncommon cause of incorrect lead connections, which can result in unnecessary investigations and treatment.