Right Axis Deviation – (more than +90 degrees): pulmonary hypertensionBlood pressure above acceptable limits – above 90 mm of Hg diastolic and above 140 mm of Hg systolic. 1. Six Second ECG Guidebook (2012), T Barill, p. 167, 197, right ventricular hypertrophyAbnormal R wave progression can occur with acute myocardial infarctions and right ventricular hypertrophy. Large, dominant R waves in leads V1 and V2 may indicate posterior or lateral myocardial infarction and right ventricular hypertrophy. Poor R wave progression (i.e. not..., right bundle branch blockA bundle branch block must satisfy two criteria - a wide QRS complex and a notch in the QRS complex. To distinguish between a RBBB and a LBBB, first make certain that the rhythm is indeed supraventricular (P waves before..., normal for children, high lateral MI
Left Axis Deviation – (more negative than -30 degrees*): left ventricular hypertrophyVentricular hypertrophy is reflected in QRS axis deviation towards the hypertrophied ventricle, increased amplitude in the QRS complex, altered R wave progression, and possibly signs of ventricular strain - ST depression and T wave inversion. Note that ST changes can..., inferior MI, left bundle branch blockA bundle branch block must satisfy two criteria - a wide QRS complex and a notch in the QRS complex. To distinguish between a RBBB and a LBBB, first make certain that the rhythm is indeed supraventricular (P waves before...
Bizarre (+150 to -90 degrees): limb lead misplacement, dextrocardiaA relatively rare phenomena, with the heart located on the right side of the thorax (rather than the typical left thorax position). 1. Six Second ECG Guidebook (2012), T Barill, p. 195, occasionally with ventricular tachycardiaIs a cardiac rhythm characterized by rapidly occurring wide QRS complexes with absent or infrequent P waves evident; the absence of atrial kick, the lack of filling time, and the tendency for ventricular tachycardia to change to ventricular fibrillation makes...
*The prevailing opinion is that left axis deviation only be placed on a QRSThe electrical representation of ventricular depolarization; the atrial repolarization is also a part of the QRS. ECG interpretation relies heavily on the QRS complex. The QRS complex represents the depolarization of the ventricles. The repolarization of the atria is also... axis with a deviation of more than 30°. Many healthy elderly patients show a QRS axis between 0° and -30°. For the sake of simplicity, left axis deviation of more than 0° can be considered significant.
1. Six Second ECG GuidebookA Practice Guide to Basic and 12 Lead ECG Interpretation, written by Tracy Barill, 2012 Introduction The ability to correctly interpret an electrocardiogram (ECG), be it a simple six second strip or a 12 lead ECG, is a vital skill... (2012), T Barill, p. 170