The clinical significance of uncomplicated marked left axis deviation in men without known disease

Abstract

T HE electrocardiographic finding of marked left axis deviation occurs in a wide variety of clinical conditions.l+? These include acquired diseases which alter myocardial integrity, such as myocardial fibrosis, myocardial infarction, myocardiopathies and left ventricular hypertrophy. In addition. either congenital or acquired interruption of the conduction system may be associated with left axis deviation. Alteration of electric resistance of pulmonarytissue,resulting from chronic pulmonary disease,’ is yet another cause. Left axis deviation also occurs in individuals without clinically apparent cardiac disease. There are those who believe that, in this latter circumstance, left axis deviation is an indication of an “aging heart”; others consider it merely an indication of an altered “electrical position.” Still other observers regard left axis deviation (if it is the only finding in an apparently healthy subject) as a variant of the normal. Thus, a question requiring an answer is, ” W/tat is the clinical signz&ance of left axis deviation in the apparently flealthy individual?” Although retrospective studies have been reported,3r4 no prospective study, to our knowledge, has been made to demonstrate the incidence of cardiovascular disease in apparently healthy individuals who exhibit left axis deviation. Thus, in undertaking this study, it was our intention to determine the clinical significance of left axis deviation in apparently healthy subjects.