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Right axis deviation - common causes


Right Axis Deviation
I.
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
A.
Acute (e.g., pulmonary embolus or severe asthmatic attack)
B.
Chronic
1.
Chronic obstructive pulmonary disease
2.
Any cause of right ventricular hypertrophy (e.g., pulmonic stenosis or primary pulmonary hypertension)
V.
Lateral wall myocardial infarction
VI.
Left posterior fascicular block (exclude all other causes of right axis deviation)

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