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If the electrical axis is between -30° and -90° this is considered left axis deviation. If the electrical axis is between +90° and +180° this is considered right axis deviation (RAD). RAD is an ECG finding that arises either as an anatomically normal variant or an indicator of underlying pathology.
Nonetheless, the ECG is used to assist with the diagnosis of RVH. A post mortem study on 51 adult male patients concluded that anatomical RVH may be diagnosed using one or more of the following ECG criteria: [8] Right axis deviation of more than (or equal to) 110° (see hexaxial reference figure) R-wave dominant over S-wave in V1 or V2
The diagnosis of WPW occurs with a combination of palpitations and when an electrocardiogram (ECG) show a short PR interval and a delta wave. [3] It is a type of pre-excitation syndrome. [3] WPW syndrome may be monitored or treated with either medications or an ablation (destroying the tissues) such as with radiofrequency catheter ablation. [4]
The definition of poor R wave progression (PRWP) varies in the literature. It may be defined, for example, as R wave of less than 2–4 mm in leads V 3 or V 4 and/or presence of a reversed R wave progression, which is defined as R in V 4 < R in V 3 or R in V 3 < R in V 2 or R in V 2 < R in V 1, or any combination of these. [11]
S in V 1 + R in V 5 or V 6 (whichever is larger) ≥ 35 mm (≥ 7 large squares) R in aVL ≥ 11 mm; The Cornell voltage criteria [13] for the ECG diagnosis of LVH involve measurement of the sum of the R wave in lead aVL and the S wave in lead V 3. The Cornell criteria for LVH are: S in V 3 + R in aVL > 28 mm (men) S in V 3 + R in aVL > 20 mm ...
Ashman beats are described as wide complex QRS complexes that follow a short R-R interval preceded by a long R-R interval. [3] This short QRS complex typically has a right bundle branch block morphology and represents an aberrantly conducted complex that originates above the AV node, rather than a complex that originates in either the right or left ventricle.
Right Atrial Enlargement (RAE) increases the p wave, representing atrial depolarization, on an ECG to an amplitude > 2.5mm in lead II, an abnormality referred to as p-pulmonale, likely due to weakened right atrial myocardium close to the Sinoatrial (SA) node.
ECG will typically show a left axis deviation, while the chest X-ray may show pulmonary oligaemia or hyperaemia. The definitive investigation is, as in all congenital heart diseases, an echocardiogram, although the aforementioned tests along with clinical features might be sufficient for most cases.