Left Axis Deviation: Inferior Infarction

Report:

Sinus rhythm 60/min

Left axis deviation –60o

Inferior and anterior infarction, probably old

Comment:

Deep Q waves of inferior infarction are a common cause of LAD in cardiac patients. They distinguish infarction from LAHB, which requires rS morphology. In addition, LAHB does not have secondary R waves in inferior leads and has them in aVR. Another common cause of LAD, LBBB, does not have q or Q wave in lead 1.

In 30-40% of inferior infarcts the diagnostic Q waves disappear over the years. Often it is the LAHB which masks the previous infarction.

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