Left Axis Deviation in Electrocardiography

The electrocardiographic finding of left axis deviation (LAD) occurs in wide variety of clinical conditions yet its significance has been debated. Paul-Wood stated its presence in 10% of healthy individuals while Pryor has quoted as low as 0.2%. OBJECTIVES: To study the incidence of LAD in various cardiac disorders. Conversely, to study the incidence of various cardiac disorders presenting as LAD. To make an attempt to find out how far it is of organic significance. METHOD: The study is based on the outcome of 70 cases with LAD out of 1180 cases attending the Medicine OPD or admitted in medicine wards of N.S.C.B. Medical College & Hospital, Jabalpur (M.P). RESULTS: LAD was found in only 5.9% of the cases examined. True LAD (-30 to -90 degrees) was found in 3.8%. Among various cardiovascular disorders the highest incidence of LAD was in cardiomyopathy (33.3%). Next being ischemic heart disease (15.5%) followed by hypertension and hypertensive heart disease (6.6%). No organic heart disease (3.6%), pulmonary heart disease (3.3%), congenital heart disease (3.1%), and rheumatic heart disease (2.1%), have contributed for a very small percentage. Among the LAD cases Myocardial infarction was most common seen in 21 cases (30%). CONCLUSIONS: LAD is uncommon and was found in only 5.9% of the cases examined. True LAD (-30 to -90 degrees) was found in 3.8% of cases and it reflected a definite pathological state. The ischemic factor was found to be more responsible for production of LAD rather than hypertrophy itself alone.