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Axis Deviation

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Axis DeviationDefinitionPowerPoint PresentationMean QRS Axis CalculationSlide 5Slide 6Slide 7Slide 8Slide 9Slide 10Normal versus DeviationSlide 12Axis Deviation CriteriaSlide 14Axis deviationSlide 16Slide 17What is the axis?Slide 19Slide 20Slide 21Slide 22Slide 23Causes of Left Axis DeviationCauses of Right Axis DeviationAxis DeviationAxis DeviationChapter 5Chapter 5DefinitionDefinitionElectrical axis...Electrical axis...The general direction in the frontal plane The general direction in the frontal plane or toward which lead the QRS complex is or toward which lead the QRS complex is predominately orientedpredominately oriented...the mean direction of depolarization ...the mean direction of depolarization through the frontal plane of the heartthrough the frontal plane of the heartMean QRS Axis Mean QRS Axis CalculationCalculationLead IILead IIMean QRS Axis Mean QRS Axis CalculationCalculationGeneral rules General rules 1.1.the mean QRS axis points midway between the mean QRS axis points midway between any two leads that show tall R waves of any two leads that show tall R waves of equal height equal height 2.2.the mean QRS axis is oriented at right angles the mean QRS axis is oriented at right angles (90°) to any lead showing a bi-phasic (90°) to any lead showing a bi-phasic complex complexMean QRS Axis Mean QRS Axis CalculationCalculationMean QRS Axis Mean QRS Axis CalculationCalculationMean QRS Axis Mean QRS Axis CalculationCalculationMean QRS Axis Mean QRS Axis CalculationCalculationMean QRS Axis Mean QRS Axis CalculationCalculationNormal versus Normal versus DeviationDeviation2 ?2 ?2 ?2 ?3 ?3 ?3 ?3 ?1 ?1 ?1 ?1 ?LeftLeftRightRight + 90∘+ 90∘Axis DeviationLeftRightAxis Deviation CriteriaAxis Deviation CriteriaLEAD ILEAD ILEAD II LEAD II (or Lead aV(or Lead aVFF or III) or III)NormalNormalPositivePositivePositivePositiveLADLADPositivePositiveNegativeNegativeRADRADNegativeNegativePositivePositiveIntermediate axisIntermediate axisNegativeNegativeNegativeNegativeAxis DeviationAxis DeviationRAD = If R wave in III > R wave in IIRAD = If R wave in III > R wave in IILAD = If R wave in aVLAD = If R wave in aVLL > I; and deep S wave in > I; and deep S wave in IIIIIIAxis deviationAxis deviation????????Axis deviationAxis deviation????Axis deviationAxis deviation????What is the axis?What is the axis?RightRightWhat is the axis?What is the axis?LeftLeftWhat is the axis?What is the axis?NormalNormalWhat is the axis?What is the axis?LeftLeftWhat is the axis?What is the axis?NormalNormalWhat is the axis?What is the axis?RightRightCauses of Left Axis Causes of Left Axis DeviationDeviation• 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 arterynote: left ventricular hypertrophy is not a cause left axis deviationFYIFYICauses of Right Axis Causes of Right Axis DeviationDeviation• 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


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