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Axis Deviation

Axis Deviation. Chapter 5. Limb leads. Frontal plane. LIMB LEADS. LIMB LEADS. Limb leads. Definition. Electrical axis... ...the mean direction of the QRS complex the general direction in the frontal plane towards which the QRS complex is predominately pointed. Left. Right.

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Axis Deviation

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  1. Axis Deviation • Chapter 5

  2. Limb leads • Frontal plane

  3. LIMB LEADS

  4. LIMB LEADS

  5. Limb leads

  6. Definition • Electrical axis... • ...the mean direction of the QRS complex • the general direction in the frontal plane towards which the QRS complex is predominately pointed Left Right

  7. Mean QRS Axis Calculation • The general direction or toward which lead axis the the QRS complex is predominately oriented • Frontal axis • Only involves the 6 limb leads

  8. Mean QRS Axis Calculation

  9. Mean QRS Axis Calculation • General rule, the mean QRS axis is oriented at right angles (90°) to any lead showing a bi-phasic complex • General rule, the mean QRS axis points midway between any two leads that show tall R waves of equal height

  10. Mean QRS Axis Calculation

  11. Mean QRS Axis Calculation

  12. Mean QRS Axis Calculation

  13. Mean QRS Axis Calculation

  14. Mean QRS Axis Calculation

  15. Normal versus Deviation Left 3 ? 1 ? 2 ? Right

  16. Axis Deviation Left Right

  17. Axis deviation ? ?

  18. Axis deviation ?

  19. Axis deviation ?

  20. Causes of Left Axis Deviation FYI • left anterior hemiblock • Q waves of inferior myocardial infarction • artificial cardiac pacing • emphysema • hyperkalaemia • Wolff-Parkinson-White syndrome - right sided accessory pathway • tricuspid atresia • ostium primum ASD • injection of contrast into left coronary artery note: left ventricular hypertrophy is not a cause left axis deviation

  21. Causes of Right Axis Deviation FYI • normal finding in children and tall thin adults • right ventricular hypertrophy • chronic lung disease even without pulmonary hypertension • anterolateral myocardial infarction • left posterior hemiblock • pulmonary embolus • Wolff-Parkinson-White syndrome - left sided accessory pathway • atrial septal defect • ventricular septal defect

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