Right Axis Deviation: Causes & Reasons

Possible Causes for Right Axis Deviation

ECG shows tall, peaked P waves (P pulmonale), right axis deviation, and RVH. Echocardiogram excludes primary LV dysfunction. [accessmedicine.mhmedical.com]

Right axis deviation and low voltage may be noted in patients with pulmonary emphysema. [health.am]

Electrocardiography shows the appearance of flat or inverted T waves in the right ventricular precordial leads, right axis deviation of greater than 30° in the mean electrical [rjoson.tripod.com]

Acute Cor Pulmonale

Rightward shift of the QRS axis towards +90 degrees (vertical axis) or beyond ( right axis deviation ). [lifeinthefastlane.com]

ECG dominant R wave in lead V1 10 defined as an R wave height > 7 mm or R/S > 1 accompanied by dominant S waves in lead V6 right axis deviation secondary repolarization abnormalities [radiopaedia.org]

Right axis deviation, dominant R wave in V1 and deep S wave in V6 suggest right ventricular hypertrophy due to cor pulmonale. [lifeinthefastlane.com]

Ostium Primum Atrial Septal Defect

In primum defects left axis deviation is seen in most patients with an axis of > -30 degrees and very few patients have right axis deviation. [en.wikipedia.org]

In Primum defects left axis deviation is seen in most patients with an axis of > -30 degrees and very few patients have right axis deviation. [ipfs.io]

Normal axis or right axis deviation due to right ventricular diastolic overload. Right atrial abnormality ( may not be observed in children ). [metealpaslan.com]

Right Ventricular Hypertrophy

Example 4 Right ventricular hypertrophy in a patient with arrhythmogenic right ventricular cardiomyopathy (ARVC): Right axis deviation. [lifeinthefastlane.com]

The ECG shows right axis deviation and right ventricular hypertrophy. Click here for a more detailed ECG ECG 8. [metealpaslan.com]

[…] by, last update November 25, 2018 Electrocardiographic Features Diagnostic criteria Right axis deviation of +110° or more. [lifeinthefastlane.com]

Biventricular Hypertrophy

axis deviation. [tititudorancea.com]

In the presence of LVH – Additional signs indicating RVH : Right atrial enlargement. Right axis deviation. Tall biphasic QRS complexes in multiple leads. [lifeinthefastlane.com]

(RVH) if the following ECG criteria are presented: Right axis deviation (>90°) – This never occurs in LVH. [ecgwaves.com]

Recurrent Pulmonary Embolism

Focal oligemia, cardiomegaly and plump pulmonary arteries on chest X-ray films, right axis deviation, clockwise rotation, ST-segment depression and T-wave inversion on electrocardiograms [ncbi.nlm.nih.gov]

Review of EKGs showed a trend of increasing right axis deviation with recovery and recurrences during the previous 9 years and a current incomplete right bundle branch block [ncbi.nlm.nih.gov]

EKG showed right axis deviation, a new incomplete right bundle branch block (IRBBB), clockwise rotation, and right heart strain with inverted T waves in V1–V4 ( Figure 2 ) [nature.com]

Left Posterior Fascicular Block

The left posterior fascicular block is diagnosed by right axis deviation and by ruling out other causes of right axis deviation. [ecgguru.com]

axis deviation, alongside several other findings involving the QRS complex. [symptoma.com]

[…] ventricular hypertrophy No evidence of any other cause for right axis deviation Example ECG rS complexes in leads I and aVL qR complexes in II, III and aVF Right Axis Deviation [lifeinthefastlane.com]

Left Anterior Fascicular Block

In your differential, consider posterior fascicular blocks with right axis deviation and consider anterior fascicular blocks with left axis deviation. [inside.fammed.wisc.edu]

Left anterior fascicular block has a marked left-axis eviation and left posterior fascicular block has a marked right-axis deviation (see how to determine the heart axis ) [en.my-ekg.com]

Acute Massive Pulmonary Embolism

His electrocardiogram showed wide-complex atrial fibrillation with rapid ventricular rate of 182, right axis deviation, right ventricular hypertrophy and inferior Q waves [epmonthly.com]

[…] heart strain), -> right axis deviation -> s wave (I and aVL) > 1.5mm -> Q wave in III and aVF -> p pulmonale -> RBBB CXR: rules out other pathology, focal oligaemia, wedge [lifeinthefastlane.com]

axis deviation T-wave inversion in the right precordial leads +/- the inferior leads is seen in up to 34% of patients and is associated with high pulmonary artery pressures [radiopaedia.org]

Double Outlet Right Ventricle

ECG revealed gross right axis deviation and right ventricular hypertrophy. Echocardiogram showed features of double outlet right ventricle. [ncbi.nlm.nih.gov]

TGA like: Subpulmonary VSD with or without PS: ECG shows left ventricular (LV) volume overload with right axis deviation. [johnsonfrancis.org]

As a result of pressure and volume overload, there are signs of RV hypertrophy and there is a right axis deviation. [wikidoc.org]

Lateral Myocardial Infarction

If the QRS is negative in Lead I, the heart is pointing more to the right than normal; hence, Right Axis Deviation. [publicsafety.net]

[…] precordial R waves) Pulmonary emphysema and cor pulmonale (loss of R waves V1-3 and/or inferior Q waves with right axis deviation) Left anterior fascicular block (may see [ecg.utah.edu]

Deviation, Electrical Alternans, Ventricular Hypertrophy, Complete and Incomplete Right Bundle Branch Block, Left Anterior Fascicular Block, Left Posterior Fascicular Block [play.google.com]

Acquired Ventricular Septal Defect

[…] ventricle with right-axis deviation. [ukessays.com]

In those with pulmonary hypertension, right axis deviation, right ventricular hypertrophy (RVH) and right atrial hypertrophy (RAH) may be seen. [patient.info]

Investigations The electrocardiogram showed sinus rhythm 100 beats/min, left axis deviation, ST elevation, and T wave inversion in the anteroseptal leads. [pmj.bmj.com]

Ebstein Malformation

Right axis deviation and Right Bundle branch Block are frequently observed as well. [symptoma.com]

Note the right-axis deviation and right ventricular hypertrophy. [doi.org]

ECG showed right axis deviation but no arrhythmias. The patient was referred to the physician for complete evaluation and management. [apicareonline.com]

Taussig Bing Anomaly

Resting electrocardiogram (ECG) may show a right axis deviation, hypertrophy of the right ventricle, intraventricular conduction defects and negative T waves in leads I, avL [symptoma.com]

Resting ECG showed right axis deviation, low atrial rhythm with a heart rate of 79 beats/minute, intraventricular conduction disturbances, right ventricular hypertrophy, negative [crcd.eu]

Electrocardiogram showed right axis deviation, clockwise loop, right ventricular hypertrophy and well preserved R waves in V5–V6 reflecting LV volume overload. [journals.viamedica.pl]

Pulmonary Hypertension

Surface electrocardiogram showed right atrial and ventricular overload with right axis deviation. [ncbi.nlm.nih.gov]

INVESTIGATIONS The ECG may show right axis deviation and incomplete RBBB. A normal ECG, however, does not exclude pulmonary hypertension. [bjgp.org]

In pulmonary hypertension, the electrocardiogram (ECG) may demonstrate signs of right ventricular hypertrophy, such as tall right precordial R waves, right axis deviation [aafp.org]

Pulmonary Embolism

P pulmonale, right and left axis deviation, S 1 S 2 S 3 and S 1 Q 3 T 3 patterns, low voltage and clockwise rotation were specific, but not sensitive for APE. [ncbi.nlm.nih.gov]

[…] heart strain pattern incomplete or complete right bundle branch block prominent R wave in lead V1 right axis deviation T-wave inversion in the right precordial leads +/- [radiopaedia.org]

axis deviation, right bundle branch block (RBBB), or deep S-waves in I with Q waves in III and inverted T waves in III ('S1,Q3,T3' pattern). [patient.info]

Ventricular Septal Defect

In those with pulmonary hypertension, right axis deviation, right ventricular hypertrophy (RVH) and right atrial hypertrophy (RAH) may be seen. [patient.info]

EKG may demonstrate right atrial enlargement, right ventricular conduction delay (incomplete right bundle branch block), right ventricular dilation and right axis deviation [utmb.edu]

EKG showing superior QRS axis deviation (negative in avF) and right ventricular hypertrophy in AVSD Management CHF, if present, is managed with diuretics, ACE inhibitors, [utmb.edu]

Anterior Myocardial Infarction

deviation and those who had right-axis deviation. [circ.ahajournals.org]

[…] precordial R waves) Pulmonary emphysema and cor pulmonale (loss of R waves V1-3 and/or inferior Q waves with right axis deviation) Left anterior fascicular block (may see [ecg.utah.edu]

There was no difference in 30-day mortality between patients with left-axis deviation, patients with right-axis deviation, and patients with neither (35.4% versus 22.2% versus [circ.ahajournals.org]

Mitral Valve Stenosis

Right heart strain may produce findings of right axis deviation and right ventricular hypertrophy on ECG. [healio.com]

A presence of right axis deviation and right ventricular hypertrophy suggest severe pulmonary hypertension. [ncbi.nlm.nih.gov]

Holt-Oram Syndrome

[…] ventricular hypertrophy with right axis deviation. [annalspc.com]

Electrocardiogram showed sinus rhythm, right axis deviation, tall and peaked P waves in leads II and V2 to V6, and right ventricular hypertrophy. [jpma.org.pk]

Electrocardiogram showed normal sinus rhythm with right ventricular hypertrophy with right axis deviation. [hindawi.com]

Dilated Cardiomyopathy

Right axis deviation suggests associated right ventricular hypertrophy (i.e. biventricular enlargement ). [lifeinthefastlane.com]

"Left bundle branch block and right axis deviation: a report of 36 cases". J Electrocardiol. 33 (Suppl): 93–102. doi:10.1054/jclc.2000.20326. [en.wikipedia.org]

Right axis deviation in the presence of LVH suggests the possibility of biventricular enlargement. [lifeinthefastlane.com]

Spontaneous Pneumothorax

These findings include axis deviation, T-wave inversion, and right bundle branch block. [ncbi.nlm.nih.gov]

When an ECG has the arm leads incorrectly placed, the ECG will display right axis deviation and inversion of the P waves in lead I. [ncbi.nlm.nih.gov]

An ECG was administered; findings indicated reversal of the arm leads (right axis deviation and inverted P waves in lead I), but there was no actual limb lead reversal present [ncbi.nlm.nih.gov]

Persistent Truncus Arteriosus

ECG shows right axis deviation, right ventricular hypertrophy, and occasionally right atrial enlargement. [merck.com]

Axis may slightly deviate to the right. Echocardiography is used to establish the diagnosis. [symptoma.com]

The electrocardiogram usually shows both right and left ventricular hypertrophy. A left atrial enlargement may be present if pulmonary over-circulation is marked. [symptoma.com]

Chronic Obstructive Pulmonary Disease

[…] ventricular hypertrophy right axis deviation dominant R wave in V1 with an amplitude >7 mm often associated with "P pulmonale" (right atrial enlargement) multifocal atrial [radiopaedia.org]

deviation >110° without right bundle branch block; or some combination of these. [msdmanuals.com]

[…] laterally (to V5 or V6) deep S waves in the lateral leads (I, aVL, V5, V6) low QRS voltage amplitude of QRS complexes <5 mm in the limb leads or <10 mm in the precordial leads right [radiopaedia.org]

Aortopulmonary Septal Defect

Electrocardio-gram showed P pulmonale and features of right ventricu-lar hypertrophy and right axis deviation. 2D-echocardiography revealed severe pulmonary artery hy-pertension [alliedacademies.org]

X-ray chest revealed tracheal deviation and mediastinal shift to right. [alliedacademies.org]

[…] with dilated right atrium and ventricle and paradoxical motion of interventricular septum. [alliedacademies.org]

Thromboembolism

Findings suggestive of PE may include sinus tachycardia, right axis deviation, inverted T waves in leads V1 to V3, and a right bundle branch block. [symptoma.com]

The most commonly seen signs in the ECG are sinus tachycardia, right axis deviation, and right bundle branch block. [61] Sinus tachycardia, however, is still only found in [en.wikipedia.org]

Patent Foramen Ovale

deviation of the QRS complex while those with a secundum ASD have a right axis deviation of the QRS complex. [marmur.com]

If pulmonary hypertension is present, right ventricular hypertrophy and right axis deviation might also be present. [thecardiologyadvisor.com]

deviation of the QRS complex, while those with a secundum ASD have a right axis deviation of the QRS complex. [en.wikipedia.org]

Chronic Thromboembolic Pulmonary Hypertension

The electrocardiogram demonstrates findings of right ventricular hypertrophy (right axis deviation, dominant R-wave in V1). [phaonlineuniv.org]

Electrocardiography Right axis deviation and precordial T wave abnormalities are early signs. [slideplayer.com]

Electrocardiogram may reveal right axis deviation, right ventricular hypertrophy, and a right bundle-branch block. [anesthesiology.pubs.asahq.org]

Endocardial Cushion Defect

Clinical features- See hemodynamics Radiography- See hemodynamics ECG- Left axis deviation Counterclockwise depolarization- as initial left to right septal depolarization [heartpearls.com]

ECG shows a superiorly directed QRS axis (eg, left axis deviation or northwest axis), frequent 1st-degree AV block, left or right ventricular hypertrophy or both, and occasional [merckmanuals.com]

[…] atrial shunt, three leaflets with cleft in left atrioventriular valve Cardiac Auscultation Pulmonary flow murmur Atrioventricular regurgitation Electrocardiogram Left axis [echocardiology.org]

Patent Ductus Arteriosus

and occasionally right axis deviation are also seen (5, 8, 11). [pubs.rsna.org]

It is agreed by most authors writing on the subject that the electrocardiographic findings in patent ductus are usually normal, although prolonged P-R intervals, left axis [pubs.rsna.org]