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Pandora320
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Normal axis range
-30° to +105°
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Relative deviation
Deviation of more than 90° from one "normal" value to another "normal" value (e.g. -5° to 90°)
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Absolute deviation
Axis falls outside of normal range
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Causes of LAD
- High diaphragm
- Pregnancy
- Obesity
- Left ventricular hypertrophy
- Right ventricular infarction
- LBBB
- Abdominal tumor
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Causes of RAD
- Young patients
- Thin patients
- Dextrocardia
- Right ventricular hypertrophy
- Left ventricular infarction
- RBBB
- Emphysema
- Pulmonary infarcts/emboli
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Physiologic causes of RAD
- High Diaphragm
- Pregnancy
- Obesity
- Tall Patient
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Axis shifts toward _______ and away from _______
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Axis refers to:
- Anatomical position of the heart
- Direction of electrical flow in atria
- Magnitude and direction of total current
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QRS complexes with a shortened height due to:
- Pericardial effusion
- Obesity
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Criteria for an abnormally small amplitude for QRS complex
- Voltage of less than 5 mm in all the limb leads
- Waves of less than 10 mm in height in precordial leads
 
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Causes of RAE
- Chronic obstructive pulmonary disease (COPD)
- Pulmonary emboli
- Pulmonary hypertension
- Mitral, tricuspid, or pulmonary valve disease
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P-pulmonale
Peaked (tee-pee) P waves in Leads II and/or III > 2.5 mm
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Causes of LAE
- Severe systemic hypertension
- Aortic or mitral valve disease
- Restrictive cardiomyopathy
- Left ventricle failure
- Anything that obstructs forward flow
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P-mitrale
Notched P wave in Leads I and/or II > 0.12 sec
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Causes of RVH
- Pulmonary hypertension
- Multiple pulmonary emboli
- Primary pulmonary hypertension
- Scarring
- Valvular disease (Pulmonic insufficiency, Pulmonic stenosis)
- COPD
- VSD
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Causes of LVH
- Outflow problem, pressure overload develops when ventricle has to pump harder against resistance such as:
- -High arterial blood pressure
- -Stenosed aortic valve
- -Volume or dilation problem, volume overload
- Valvular disease:
- -Aortic insufficiency
- -Aortic stenosis
- -Mitral insufficiency
- Hypertension
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IVCD
Interventricular Conduction Delays
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Length of QRS complex in a BBB
- QRS >= 0.12 sec
- Slow because impulse has to travel cell to cell
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Causes of RBBB
- Idiopathic degeneration of conduction fibers
- Ischemic heart disease (of anterior septum)
- Small area of infarction
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RBBB
Notched (bunny ears) in QRS in V1, V2
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Causes of LBBB
- Widespread myocardial disease
- Degenerative disease of conduction system
- Ischemic heart disease
- Causes of LVH
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LBBB
Notched (bunny ears) in QRS in V5, V6
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If LBBB is present (Notched QRS in V5 and/or V6)....
Can't diagnose LVH or RVH
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If RBBB is present (Notched QRS in V1 and/or V2)....
Can't diagnose RVH, but use criteria to determine LVH
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Early warning of impending infarction
Spontaneous appearance of Mobitz AV Block or BBB
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Incomplete BBB or right/left ventricular conduction delay
If QRS < 0.12 but RSR’ present
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