Abstract

The electrocardiograms of 154 patients with left axis deviation of the QRS of between −30 and −90 degrees (LAD) were correlated with the findings clinically and at necropsy. Only 4 patients (2.6 per cent) did not have cardiac abnormality, even though in 17 patients the electrocardiograms were normal except for the left axis deviation (LAD). Myocardial infarction was present in 52 per cent of the patients, and unequivocal coronary artery disease in an additional 13 per cent. The angle between the mean initial 0.04-second and mean terminal QRS vectors was of little value in predicting the presence of myocardial infarction. Emphysema was thought to have only a contributory role in producing LAD. The data on 100 consecutive living patients with LAD and on 100 consecutive living patients under 40 years of age were interpreted as affording additional support to the conclusion that LAD, with rare exception, is electrocardiographic evidence of cardiac abnormality.

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