Right axis deviation - common causes

Right Axis Deviation

Spurious: left-right arm electrode reversal (look for negative P wave and negative QRS complex in lead I)

II.

Normal variant

III.

Dextrocardia

IV.

Right ventricular overload

Acute (e.g., pulmonary embolus or severe asthmatic attack)

Chronic

	1.	Chronic obstructive pulmonary disease
	2.	Any cause of right ventricular hypertrophy (e.g., pulmonic stenosis or primary pulmonary hypertension)

Lateral wall myocardial infarction

VI.

Left posterior fascicular block (exclude all other causes of right axis deviation)

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