Key result
Ischemia in the territory of the first major septal perforator branch anomalously originating from the first diagonal branch led to a transient leftward shift of the QRS axis.
Case Report (n=1)
No
Ischemia in the territory of an anomalously originating first major septal perforator branch can cause a transient leftward QRS axis shift on ECG.
Transient QRS axis shift warrants consideration of anomalous septal perforator ischemia; leaves open prospective validation in larger cohorts.
A patient with non-Q wave myocardial infarction had severe luminal narrowing in the first major septal perforator branch, which arose anomalously from the first diagonal branch. In this case, an exercise ECG showed a transient leftward QRS axis shift.
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Kodama-Takahashi et al. (2003) conducted a case report in Non-Q wave myocardial infarction (n=1). Ischemia in the territory of the anomalous first major septal perforator branch was evaluated on Transient leftward QRS axis shift. Ischemia in the territory of the first major septal perforator branch anomalously originating from the first diagonal branch led to a transient leftward shift of the QRS axis.
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