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Usually, left ventricles makes up most of the heart muscles, so a normal cardiac axis is directed downward and slightly to the left. In a normal axis, QRS is between -30° and +90°. In contrast to that, left axis deviation (LAD) is defined as QRS axis between −30° and −90°, and right axis deviation is defined as QRS axis greater than +90 ...
Left anterior fascicular block (LAFB) is an abnormal condition of the left ventricle of the heart, [1] [2] related to, but distinguished from, left bundle branch block (LBBB). It is caused by only the left anterior fascicle – one half of the left bundle branch being defective. It is manifested on the ECG by left axis deviation.
On ECG a left axis deviation is generally found in ostium primum ASD, but an RSR pattern (M pattern) in V1 is characteristic. Fixed splitting of the second heart sound (S2) occurs because of equal filling of the left and right atria during all phases of the respiratory cycle. [citation needed] ECG of a patient with Ostium primum ASD
The pathophysiology depends on the specific cause of right axis deviation. Most causes can be attributed to one of four main mechanisms. [14] [15] These include right ventricular hypertrophy, reduced muscle mass of left ventricle, altered conduction pathways and change in the position of the heart in the chest. [citation needed]
Beyond +105° is right axis deviation and beyond −30° is left axis deviation (the third quadrant of −90° to −180° is very rare and is an indeterminate axis). A shortcut for determining if the QRS axis is normal is if the QRS complex is mostly positive in lead I and lead II (or lead I and aVF if +90° is the upper limit of normal).
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.
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Left bundle branch block (LBBB) is a conduction abnormality in the heart that can be seen on an electrocardiogram (ECG). [1] In this condition, activation of the left ventricle of the heart is delayed, which causes the left ventricle to contract later than the right ventricle .
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