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In electrocardiography, left axis deviation (LAD) is a condition wherein the mean electrical axis of ventricular contraction of the heart lies in a frontal plane direction between −30° and −90°. This is reflected by a QRS complex positive in lead I and negative in leads aVF and II. [1] There are several potential causes of LAD.
The LAD gives off two types of branches: septals and diagonals. Septals originate from the LAD at 90 degrees to the surface of the heart, perforating and supplying the anterior 2/3 of the interventricular septum. Diagonals run along the surface of the heart and supply the lateral wall of the left ventricle and the anterolateral papillary muscle.
LAFB cannot be diagnosed when a prior inferior wall myocardial infarction (IMI) is evident on the ECG. IMI can also cause extreme left-axis deviation, but will manifest with Q-waves in the inferior leads II, III, and aVF. By contrast, QRS complexes in the inferior leads should begin with r-waves in LAFB. [citation needed]
Wellens' syndrome is an electrocardiographic manifestation of critical proximal left anterior descending (LAD) coronary artery stenosis in people with unstable angina. Originally thought of as two separate types, A and B, it is now considered an evolving wave form, initially of biphasic T wave inversions and later becoming symmetrical, often ...
de Winter syndrome is an electrocardiogram (ECG) pattern which often represents sudden near blockage of the left anterior descending artery (LAD). [1] [5] Symptoms include chest pain, shortness of breath, and sweating. [1] While typically due to blockage of the LAD, other arteries of the heart may be involved. [1]
Under these criteria, an ECG is positive for an AMI in the presence of LBBB if any of the following criteria are present: ST deviation ≥1 mm (0.1 mV) concordant with QRS polarity in any ECG lead, thus including either: ST depression ≥1 mm (0.1 mV) concordant with QRS polarity, in any ECG lead.
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