Left Axis Deviation

left axis deviation means that the overall direction of ventricular depolarisation is abormal and too far around towards the left shoulder. This direction can be between -30 degrees (up towards the left shoulder) to -90 degrees (vertically upwards) from horizontal. If the axis is leftward, Lead I will be positive, aVF negative and lead II negative. Left Axis Deviation can be caused by lots of things, including left ventricular hypertrophy, left bundle branch block, inferior MI, ventricular pacing, and others. The diagnosis of exclusion is left anterior fascicular block.

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In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Fragmented QRS Left Axis Deviation ECG Interpretation CC-BY-NC-SA
ECG Blog #165 (MI – Acute – Old – Unknown Age – Aneurysm – Fragmentation) 30625
In the ECGquest archives, this ECG has been tagged with: - Syncope 12-Lead Fragmented QRS Left Axis Deviation Regular Tachycardia ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG : Syncope and tachycardia 29273

This ECG is from a man in his 50s who presented with syncope on a background of diabetes, opiate abuse and possible prior cardiac disease.

This ECG shows a supraventricular tachycardia with evidence of P waves, left axis deviation and slightly wider QRS (106 msec) likely due to LAFB, tall QRS concerning for LVH and fragmentation in V2-4 suggesting prior MI.

In the ECGquest archives, this ECG has been tagged with: - Syncope 12-Lead Left Axis Deviation Long PR Normal rate RSR' Wide QRS First degree AV block LAFB RBBB Trifascicular block ECG of the Week CC-BY-NC-SA
ECG of the Week – 26th November 2018 – Interpretation 28721

This ECG is from a man in his 60s who presented after an episode of syncope.

This ECG shows bifascicular block (RBBB + LAFB) with a first degree AV block. He underwent pacemaker insertion.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Left Axis Deviation Bifascicular block LAFB RBBB ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Bifascicular Block 27903

This ECG is from a woman in her 70s who presented with sepsis.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Bradycardia Extra P waves Left Axis Deviation Second degree AV block 2:1 ECG of the Week CC-BY-NC-SA
ECG of the Week – 29th October 2018 – Interpretation 27692

This ECG is from a woman in her 80s who presented with intermittent chest pain and dyspnoea.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Left Axis Deviation Long PR Normal rate Regular Acute Anterior MI ECG of the Week CC-BY-NC-SA
ECG of the Week – 22nd October 2018 – Interpretation 27668
In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Electrode misplacement Lateral ST elevation Left Axis Deviation LAFB RBBB Acute Anterior MI Acute Lateral MI Dr Smith's ECG Blog CC BY-NC
A man in his 80s with chest pain 27868

This ECG is from a man in his 80s who presented with chest pain and shortness of breath. This was the repeat ECG just before he arrested.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Left Axis Deviation Long PR Pathological Q waves Regular Wide QRS First degree AV block RBBB ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Right Bundle Branch Block With Probable Previous M.I. 27473

This ECG is from an 87 year old man who presented with chest discomfort.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Excessive discordant ST depression. Excessive discordant ST elevation Left Axis Deviation R in aVR Regular Tachycardia Wide QRS Ventricular tachycardia Acute Lateral MI Acute Posterior MI Dr Smith's ECG Blog CC BY-NC
Posterolateral OMI resulting in VT, then R-on-T phenomenon and VF – repeat after sudden worsening of shortness of breath. 27573

This ECG is from a man in his 50s who presented with 1 hour of chest pain and shortness of breath. This was his second ECG after he suddenly became more short of breath.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Bradycardia Left Axis Deviation Sinus bradycardia Dr Smith's ECG Blog CC BY-NC
A Tale of 2 Occlusions in the Same Patient: one with Expert ECG interpretation, the Other Without 27462

This ECG is from a man in his 40s who presented with chest discomfort and diaphoresis since waking a few hours earlier. He had just been given aspirin followed by significant relief from the pain.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Serial 12-lead Hyperacute T waves Left Axis Deviation Sinus bradycardia Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A Tale of 2 Occlusions in the Same Patient: one with Expert ECG interpretation, the Other Without – second ECG, as pain returned 40 min later 27496

This ECG is from a man in his 40s who presented with chest discomfort and diaphoresis since waking a few hours earlier, on a background of prior infarction with PCI years ago, active smoking, high cholesterol and hypertension. This was the repeat ECG 40 min after arrival, when pain returned.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Serial 12-lead Anterior ST elevation Hyperacute T waves Inferior ST elevation Left Axis Deviation Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A Tale of 2 Occlusions in the Same Patient: one with Expert ECG interpretation, the Other Without – repeat with worsening pain 27498

This ECG is from a man in his 40s who presented with chest discomfort and diaphoresis since waking a few hours earlier, on a background of prior infarction with PCI years ago, active smoking, high cholesterol and hypertension. This was the repeat ECG 12 minutes after the pain increased.

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