Left Axis Deviation Archives

Case 37: An 81-Year-Old Man with a History of Myocardial Infarction

Case 37: An 81-Year-Old Man with a History of Myocardial Infarction History Diagnosis History An 81-year-old man suffered from a myocardial infarction 5 years ago. He has been stable and free of angina, but recently he has been concerned about palpitation: Diagnosis Sinus rhythm, 82/min with premature atrial complexes Left axis deviation (QRS positive in …

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Case 57: A 78-Year-Old Man at a Routine Office Visit

Practice Level 2

Case 57: A 78-Year-Old Man at a Routine Office Visit History Diagnosis History A 78-year-old moderately active man without chest pain or dyspnea is seen by his family physician for a routine examination: Diagnosis Sinus rhythm Left axis deviation (QRS positive in lead I, negative in aVF and II) Left anterior fascicular block ECG …

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Case 27: A 70-Year-Old Man in the ICU with Respiratory Failure

Practice Level 3

Case 27: A 70-Year-Old Man in the ICU with Respiratory Failure History Diagnosis History This 70-year-old man with COPD is admitted to the ICU with severe respiratory failure: Diagnosis Atrial flutter with 2:1 AV conduction (changing to variable AV conduction during the last 2 seconds of recording) Left axis deviation Low QRS voltage in the …

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Case 37: A 63-Year-Old Woman in the Cardiac Clinic for Reassessment

Practice Level 3

Case 37: A 63-Year-Old Woman in the Cardiac Clinic for Reassessment History Diagnosis History A 63-year-old woman with a 4 year history of coronary artery disease is in the cardiac clinic for reassessment. She is stable, with infrequent mild angina on exertion: Diagnosis Sinus tachycardia with frequent non-conducted premature atrial complexes (PAC) Left axis deviation …

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Case 66: An 89-Year-Old Man in the ICU

Practice Level 3

Case 66: An 89-Year-Old Man in the ICU History Diagnosis ECG 2 ECG 2 Diagnosis History An 89-year-old man with hypertension, diabetes and coronary artery disease suffered cardiac arrest at home. When the Emergency Medical Service arrived he was pulseless, but shortly afterwards there was spontaneous return of circulation. He is admitted to ICU and …

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Case 76: A 78-Year-Old Man with Severe Aortic Stenosis

Practice Level 3

Case 76: A 78-Year-Old Man with Severe Aortic Stenosis History Diagnosis History A 78-year-old man is admitted for investigation of severe aortic stenosis: Diagnosis Sinus rhythm Left axis deviation Left bundle branch block A commonly asked QUESTION is: “Why in this case of left bundle branch block the QRS in leads V5 and V6 is negative, instead …

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Case 79: An 84-Year-Old Woman in the Medical ICU

Practice Level 3

Case 79: A 84-Year-Old Woman in the Medical ICU History Diagnosis History A 84-year-old woman with a long history of chronic obstructive pulmonary disease and asthma is admitted to the ICU with pneumonia: Diagnosis Multifocal atrial tachycardia (MAT), 138/min Left axis deviation Non-specific ST and T wave abnormality The computer program misdiagnosed the arrhythmia as …

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Case 94: A 23-Year-Old man with Acute Chest Pain who Collapsed

Practice Level 3

Case 94: A 23-Year-Old man with Acute Chest Pain who Collapsed History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History A 23-year-old man with previous history of alcohol abuse and use of marijuana and cocaine was in a nightclub, drinking alcohol and smoking marijuana, when he developed severe anterior chest pain, …

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Case 98: An 89-Year-Old Woman in the Emergency Department

Practice Level 3

Case 98: A 89-Year-Old Woman in the Emergency Department History Diagnosis History A 89-year-old woman is referred to the Emergency Department from a nursing home, complaining of feeling lightheaded and weak and is treated for hypertension: Diagnosis Marked sinus bradycardia with marked sinus arrhythmia Left axis deviation Left ventricular hypertrophy ECG ID: E268

Case 99: A 77-Year-Old Man in the Emergency with Dyspnea

Practice Level 3

Case 99: A 77-Year-Old Man in the Emergency with Dyspnea History Diagnosis History A 77-year-old man with a long history of coronary artery disease is in the Emergency Department complaining of dyspnea and oppressive anterior chest discomfort: Diagnosis Atrial flutter with 2:1 conduction Ventricular rate 120/min Left axis deviation Septal myocardial infarction, age undetermined ECG …

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