Left QRS Axis
Criteria
- QRS axis < -30 °
- QRS axis >= -90 °
Causes
- Left Ventricular HypertrophyLeft axis deviation can be caused by left ventricular hypertrophy.
- Left Bundle Branch BlockLeft axis deviation can be caused by a left bundle branch block.
- Inferior ST ElevationLeft axis deviation can be caused by an inferior MI.
- Ventricular PacingLeft axis deviation can be caused by a ventricular pacemaker.
- Premature Ventricular ComplexLeft axis deviation can be caused by a ventricular ectopic beat.
- Wolff Parkinson White SyndromeLeft axis deviation can be caused by Wolff Parkinson White syndrome.
- Left Anterior Fascicular BlockLeft axis deviation can be caused by a left anterior fascicular block, which is the diagnosis of exclusion.
- Normal ECGLeft axis deviation can be caused by a horizontally orientated heart in a short, squat patient.
- Atrial Septal DefectLeft axis deviation can be caused by a Primum ASD.
Abbreviation
- Left Axis
Abbreviations
Synonyms
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Anterior Ischemia (ISCAN) Anterolateral Ischemia (ISCAL) Anteroseptal Ischemia (ISCAS) D1 Occlusion D2 Occlusion Inferior aneurysm (Inf aneurysm) Inferior Ischemia (ISCIN) Inferolateral Ischemia (ISCIL) LAD occlusion Lateral ischemia (ISCLA) LCx Occlusion Left Main Occlusion Ramus Intermedius Occlusion RCA Occlusion Subendocardial injury in anterolateral leads (INJAL) Subendocardial injury in anteroseptal leads (INJAS) Subendocardial injury in inferior leads (INJIN) Subendocardial injury in lateral leads (INJLA) Wall Motion Abnormality 1:1 P:QRS Abdominal Pain (Abdo Pain) Active Chest Pain Adult Baseline Artefact Baseline ECG Bigeminy (Bigem) Cardiac Arrest (Arrest) Chest Leads Chest Pain Dizziness (Dizzy) Dyspnoea (SOB) Female Fits, Faints and Funny Turns Hypertension (HTN) Initial ECG Limb Leads Loss of Consciousness (LOC) Male Normal ECG (Normal) Normal P Wave (Normal P) Normal PR Interval (Normal PR) Normal PR Segment Normal Q Wave (Normal Q) Normal QRS Axis (Normal Axis) Normal QRS Transition (Normal Transition) Normal QT Interval (Normal QT) Normal Rate Normal Sinus Rhythm (NSR) Normal ST Segment (Normal ST) Normal T Wave (Normal T) Palpitations (Palps) Post-Intervention ECG Pregnant Regular Rhythm (Regular) Resolved Chest Pain Rhythm Strip Only Seizure (Seizure) Serial ECG Standard 12-lead (12-lead) Standard Calibration (Standard Calib) Syncope Vomiting (Vomit) Weakness (Weak) 2:1 P:QRS 3:1 P:QRS 4:1 or Higher P:QRS Abnormal QRS (Abn QRS) Asystole Atrial Fibrillation (AF) Atrial Flutter (AFlutter) Basic Hyperacute T waves MI T>R Biphasic T Wave (Biphasic T) Bradycardia (Brady) Change in Rhythm (Δ Rhythm) Chest Compression Artefact (Chest Compressions) Classic Anterior MI (Anterior MI) Classic Inferior MI Classic Inferoposterior MI Concave ST Elevation Convex ST Elevation Coved ST Elevation Diffuse Subendocardial Ischaemia Disrupted QRS Transition Double Speed Calibration (Double Speed) Downsloping ST Depression (STD Downsloping) Dynamic Changes (Dynamic) Electrical Interference Artefact (Electrical Artefact) Electrode Detachment (Electrode Off) Fibrillation Wave (Fib wave) First Degree AV Block (1°AVB) Flat ST Segment (Flat ST) Flat T Wave (Flat T) Flutter P Wave (Flutter) Half Height Calibration (Half Height) High Lateral MI Horizontal ST Depression (STD Horizontal) Hyperacute T MI - Bulky Hyperacute T MI - Tall Inverted T Wave (Tinv) Irregular Rhythm (Irreg) Left Atrial Enlargement (LAE) Left Bundle Branch Block (LBBB) Left QRS Axis (Left Axis) Long PR Interval (Long PR) Long QT Interval (Long QT) Low QRS Multiple Rhythms Narrow QRS Pacemaker Spikes (Pacing Spikes) Pathological Q Wave Posterior Leads PR Segment Depression (PR depress) PR Segment Elevation Premature Complex (Premature Beat) Pulseless Electrical Activity (PEA) Right Atrial Enlargement (RAE) Right Bundle Branch Block (RBBB) Right Leads Right QRS Axis (Right Axis) Saddleback ST Elevation (STE Saddleback) Short PR Interval (Short PR) Short QT Interval (Short QT) Sinus Arrhythmia Sinus Bradycardia (Sinus Brady) Sinus Tachycardia (Sinus Tach) ST Depression (STD) ST Elevation (STE) Straightened ST Segment (Straight ST) Supraventricular Tachycardia (SVT) Tachycardia (Tachy) Tall P Wave (Tall P) Tall QRS Tall T Wave (Tall T) Tombstone ST Elevation (Tombstones) Torsades de Pointes (TdP) U Wave Upsloping ST Depression (STD Upsloping) Variable P:QRS Ventricular Fibrillation (VF) Ventricular Tachycardia (VT) Wandering Baseline (Baseline wander) Wide Bifid P Wave (Wide P) Wide Complex Tachycardia (WCT) Wide QRS (Wide QRS) A-V Sequential Pacing (A-V Paced) Absent P Wave (Absent P) Accelerated Idio Ventricular Rhythm (AIVR) Accelerated Junctional Rhythm (Accel Junctional) Anterior ST Depression (STD anterior) Anterior ST Elevation (Anterior STE) Asymmetrical P in V1 (Asymm P V1) Athlete's Heart Atrial Bigeminy Atrial Escape Atrial Escape Beat (AEB) Atrial Fibrillation with Rapid Ventricular Response (AF + RVR) Atrial Flutter + Variable Block (AFlutter Variable) Atrial Pacing (Atrial Paced) Atrial Tachycardia (ATach) Atrioventricular Node Re-entrant Tachycardia (AVNRT) Atrioventricular Re-entry Tachycardia (AVRT) Benign T wave Inversion (Benign Tinv) Bifid T Wave Biphasic Down-Up T wave Biphasic Up-Down T Wave (Up-Down T) Biventricular pacing (Bivent paced) Brugada Syndrome Chronic Obstructive Pulmonary Disease (COPD) Classic AnteroLateral MI (AntLat MI) Classic Inferolateral MI (InfLat MI) Classic InferoPosteroLateral MI (InfPostLat MI) Classic Lateral MI (Lat MI) Classic Wellens A MI (Wellens A) Classic Wellens B MI (Wellens B MI) Concordant ST Elevation (Concordant STE) Couplet Critical Arrhythmia Critical Electrolyte Abnormality Dagger Q Wave De Winter T MI Delta Wave Dextrocardia Discordant ST Changes (Discordant ST) Downsloping TP Segment Early QRS Transition (Early Transition) Electrode Misplacement (Misplaced) Extreme QRS Axis (Extreme Axis) Focal Atrial Tachycardia (Atrial Tach) Gastrointestinal Bleeding (GI Bleed) Grouped Rhythm (Grouped) Hidden P Wave (Hidden P) High Grade AV Block (High Grade AVB) High V1/V2 Misplacement (High V1/V2) Hyperacute T Wave (HyperT) Hyperacute T with Upsloping ST Depression (DeWinter T) Hypercalcaemia (HyperCa) Hyperkalemia (HyperK) Hyperthermia Hyperthyroidism Hypocalcaemia (HypoCa) Hypokalemia (HypoK) Hypomagnesaemia (HypoMg) Hypothermia Hypothyroidism Inappropriate Sinus Tachycardia Incomplete Left Bundle Branch Block (iLBBB) Incomplete Right Bundle Branch Block (iRBBB) Indeterminate QRS Axis (Indeterminate Axis) Inferior ST Depression (Inf STD) Inferior ST Elevation (Inf STE) Intermittent Left Bundle Branch Block (Int LBBB) Interrupted Rhythm (Interrupted) Intra-Ventricular Conduction Delay (IVCD) Inverted P Wave (Inv P) Inverted U Wave (Inv U) Isolated Posterior MI Junctional Bradycardia (Junctional Brady) Junctional Escape Junctional Escape Beat (JEB) Junctional Tachycardia LA/RA Electrode Reversal (LA/RA) LAFB Bifascicular Block (LAFB + RBBB) Late QRS Transition (Late Transition) Lateral ST Depression (STD lateral) Lateral ST Elevation (Lateral STE) Left Anterior Fascicular Block (LAFB) Left Main Critical Stenosis (LMCA Stenosis) Left Posterior Fascicular Block (LPFB) Left Ventricular Hypertrophy (LVH) Left Ventricular Strain Lengthening PR Interval (Lengthening PR) Long QT syndrome (Long QT Synd) Lown Ganong Levine Syndrome (LGL) LPFB Bifascicular Block (LPFB + RBBB) Machine Interpretation Error Mitral stenosis (MS) Monitor and Investigate Further Monomorphic Ventricular Tachycardia (monoVT) Multifocal Atrial Tachycardia (MAT) Myocardial infarction (MI) Myocardial Ischemia (Ischemia) No Rate Non-Sustained Ventricular Tachycardia (NSVT) Nondiagnostic ECG Nonspecific T Wave Changes Normal Angiogram (Normal Angio) Normal Variant ST Elevation Notched J Point Obesity Old Anterior MI Old Inferior MI Old Lateral MI Osborn Wave Peaked T Wave (Peaked T) Pericardial Effusion Pericarditis Pneumothorax Polymorphic Ventricular Tachycardia (PMVT) Premature Atrial Complex (PAC) Premature Junctional Complex (PJC) Premature Ventricular Complex (PVC) Proximal LAD MI – aVR Proximal LAD MI- RBBB Pulmonary Embolism (PE) QRS Alternans QRS Twisting Quadrigeminy R in aVR Rate Controlled Atrial Fibrillation Rate-related ST Depression (Rate-related STD) Reciprocal ST Depression (Recip STD) Retrograde P Wave (Retro P) Right Ventricular Hypertrophy (RVH) Right Ventricular MI - V1 Right Ventricular MI – V4R Right Ventricular Strain rSR' RSr' (RSR') S1Q3T3 Second Degree AV Block (2°AVB) Second Degree AV Block 2:1 (2°AVB 2:1) Second Degree AV Block Mobitz Type 1 - Wenckebach (Wenckebach) Second Degree AV Block Mobitz Type 2 (Mobitz 2) Secondary Repolarisation Changes (2° Repol Δ) Sepsis Septal ST Elevation (Septal STE) Short QT Syndrome Sick Sinus Syndrome (SSS) Sine Wave Sinus Arrest Sinus Pause Slow Atrial Fibrillation Slow Atrial Flutter (Slow AFlutter) ST Depression in aVL ST Elevation in aVL ST Elevation in aVR ST Elevation in Posterior Leads V7-9 ST Elevation in V1 ST Elevation in V4R Subendocardial injury in inferolateral leads (INJIL) T-U Wave (T-U) Ta Wave Tall U Wave (Tall U) Terminal QRS Distortion MI Third Degree AV Block (3°AVB) TP Wave Trifascicular Block Trigeminy Urgent Reperfusion Needed Variable P Wave (Variable P) Variable PR Interval (Variable PR) Variable Second Degree AV Block (Variable AVB) Ventricular Bigeminy (Vent Bigeminy) Ventricular Escape Ventricular Escape Beat (VEB) Ventricular Flutter (VFlutter) Ventricular Pacing Ventricular Standstill Vertical QRS Axis Wandering Atrial Pacemaker (WAP) Widespread ST Depression (STD Widespread) Widespread ST Elevation (Widespread STE) Wolff Parkinson White Syndrome (WPW) Wraparound LAD MI Absence of RS Absent Q Wave in V5-6 Anasarca Anorexia nervosa (Anorexia) Antidromic AVRT (AVRT Anti) Aortic Dissection Aortic Stenosis Arrhythmogenic Right Ventricular Cardiomyopathy (ARVD) Aslanger Pattern MI ASTE Formula False Negative ASTE Formula False Positive ASTE Formula Negative ASTE Formula Positive Atrial Infarction (Atrial MI) Atrial Septal Defect AV Dissociation Beta Blocker Toxicity Biatrial Enlargement Bidirectional Ventricular Tachycardia (BiVT) Bifid T waves (Bifid T) Biventricular Hypertrophy Blocked Premature Atrial Complex (Blocked PAC) BRASH Brugada Syndrome Type 1 (Brugada 1) Brugada Syndrome Type 2 Brugada Syndrome Type 3 (Brugada 3) Bundle Branch Reentrant Ventricular Tachycardia (BBVT) Calcium Channel Blocker Toxicity Capture Beat (Capture) Carbamazepine Toxicity Cardiac T Wave Memory (T Memory) Cardiomyoplasty Artefact CerebroVascular Accident Changing QRS Axis Cocaine Toxicity Concordant ST Depression in V1-V3 (Concordant STD V1-3) Cor Pulmonale Coronary Artery Dissection (Coronary Dissection) Coronary Artery Spasm Coronary Embolism Crochetage sign (Crochetage) Deeply Inverted T Wave Delayed activation wave Digoxin Effect Digoxin Toxicity (Dig Tox) Dilated Cardiomyopathy Dominant S in V5 or V6 Early Repolarisation with Dynamic T Wave Epsilon Wave (Epsilon) Excessive Discordant ST Depression (Excess Disc. STD) Excessive Discordant ST Elevation (Excess Disc. STE) Failure to Capture Failure To Inhibit Failure to Sense Familial Catecholaminergic Polymorphic Ventricular Tachycardia Fascicular Ventricular Tachycardia (FVT) Fast-Slow AVNRT Fistula Artifact Flecainide Toxicity (Flecainide) Fragmented QRS Fragmented QRS MI Fusion Beat Hemochromatosis Hiatus Hernia High Lateral D1 MI Hydroxychloroquine toxicity Hypertrophic Cardiomyopathy ICD Overdrive Pacing Inferior Wellens A MI Inferior Wellens B MI Intermittent Right Bundle Branch Block (Intermittent RBBB) Interpolated Premature Ventricular Complex Jervell-Lange-Nielson syndrome Juvenile T Wave Pattern Kounis Syndrome LA/LL and RA/RL Electrode Reversal (LA/LL + RA/RL) LA/LL Electrode Reversal (LA/LL) LA/RL Electrode Reversal (LA/RL) LCx Occlusion with Bifascicular block (LCx + Bifasc Block) Lead I Sign Left Main Occlusion with New Bifascicular Block Left P Axis Left Ventricular Aneurysm (LV Aneurysm) Left Ventricular Hypertrophy LAD MI (LVH + LAD MI) Left Ventricular Hypertrophy LCx MI (LVH LCx MI) Left Ventricular Hypertrophy RCA MI (LVH RCA MI) Lewis Lead Long R Wave Peak Time Long RS Interval Loss of Precordial T Wave Balance Masquerading Bundle Branch Block (MBBB) Metabolic Acidosis Metabolic alkalosis MI Resembles BER Missed MI Modified Sgarbossa Negative (Sgarb Neg) Multi-Vessel Disease Muscular Dystrophy Myocardial Bridging Myocardial Contusion Myocardial Infarction With Non-obstructive Coronary Arteries (MINOCA) Myocardial Rupture Myocarditis Myopericarditis No Reflow (No reflow) Normal P Axis Normal Paediatric T wave Pattern (Normal Paeds T) Normal QRST angle Normal T Axis Notched S Wave Nadir Notched Wide R Wave Notched Wide S Wave (Cabrera) Orthodromic AVRT (AVRT Ortho) Pacemaker Lead Misplacement (Pacing Lead Error) Pacemaker Mediated Tachycardia Phaeochromocytoma (Phaeo) Pleomorphic Ventricular Tachycardia (Pleomorphic VT) Post Electrical Cardioversion Posterior + RBBB MI Posterior Wellens MI Postinfarction Regional Pericarditis (PIRP) Prinzmetal Angina Propranolol Toxicity Proximal LAD MI with Bifascicular Block (Prox LAD MI - Bifasc) Pseudo R' Wave (Pseudo R') Pseudo-Normalised ST Segment (Pseudo-Normal ST) Pseudo-Normalised T Wave (Pseudo-Normal T) Pseudofusion Q Wave LAD MI (Q Wave LAD MI) Q Wave RCA MI Quetiapine Toxicity Quinidine Toxicity R in V1 RA/LL Electrode Reversal RA/RL Electrode Reversal Raised Intracranial Pressure Re-occlusion Regularised AF Reperfusion Reperfusion T Wave Restrictive Cardiomyopathy Reverse QRS Transition Reverse Takotsubo Right P Axis Right Ventricular Outflow Tract Tachycardia (RVOT) Romano Ward syndrome Runaway Pacemaker Sarcoidosis (Sarcoid) Scleroderma Second Degree SA Block Type I (2°SAB Type 1) Second Degree SA Block Type II (2°SAB type 2) Septal Hypertrophy Sgarbossa LBBB Antero-Inferior MI (LBBB Antero-Inf MI) Sgarbossa LBBB High Lateral MI (LBBB High Lateral MI) Sgarbossa LBBB Inferoposterior MI (LBBB Inferopost MI) Sgarbossa Paced Anterior MI (Paced Anterior MI) Sgarbossa Paced Inferoposterior MI (Paced Inferopost MI) Sgarbossa Paced Isolated Posterior MI (Paced Posterior MI) Sgarbossa Paced Lateral MI Sinus Node Re-entrant Tachycardia (SNRT) Slow-Fast AVNRT Slow-Slow AVNRT Slurred S in V6 Sodium Channel Blocker Toxicity (NaBlocker) Sotalol Toxicity ST Elevation in a PVC ST Elevation in III>II Sub-Arachnoid Haemorrhage (SAH) Subtle Anterior MI Subtle High Lateral MI Subtle Inferior Reciprocal Change MI Subtle Inferoposterior MI Subtle Lateral MI (Subtle Lateral MI) Subtle MI - Loss of R Progression Only Subtle Right Ventricular MI (Subtle RV MI) Subtle TWI in aVL MI Subtotal LAD occlusion (Subtotal LAD) SVT with Aberrancy Takotsubo Cardiomyopathy (Takotsubo) Tall Biphasic Mid-Precordial QRS Tall Upright T in V1 Terminal QRS Distortion Transcutaneous Pacing Artefact Transient MI Transient Q wave Transient ST Elevation Type II MI Unknown Toxic Ingestion (Tox) Widened QRST Angle Wolff Parkinson White Syndrome Type A (WPW Type A) Wolff Parkinson White Syndrome Type B (WPW Type B) Ashman Beat Bundgaard syndrome (Bundgaard) Concealed conduction (Concealed) Coronary Sinus Rhythm Double Tachycardia First Degree SA Block (1°SAB) Fontaine Leads Haissaguerre Syndrome Infant Normal QT Interval Isorhythmic Dissociation Left Ventricular Noncompaction Cardiomyopathy (LV Noncompaction) Lenègre-Lev disease (Lenègre) Neonatal Normal QRS Axis Paediatric (Paeds) Paediatric First Degree AV Block Paediatric Left Bundle Branch Block Paediatric Left Ventricular Hypertrophy Paediatric Neonatal T Wave Paediatric Normal PR Interval Paediatric Normal QRS Axis (Paed Normal Axis) Paediatric Right Bundle Branch Block Paediatric Right Ventricular Hypertrophy Paediatric Ventricular Tachycardia Paediatric Wide QRS Parasystole Pseudo Brugada Shark Fin ST Elevation (Shark Fin) Sinoventricular Rhythm Spiked Helmet Sign Third Degree SA Block (3°SAB) Ventriculophasic Arrhythmia
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