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ECG - Right Axis Deviation
Related Subjects: |ECG Basics |ECG Axis |ECG Analysis |ECG LAD |ECG RAD |ECG Low voltage |ECG Pathological Q waves |ECG ST/T wave changes |ECG LBBB |ECG RBBB |ECG short PR |ECG Heart Block |ECG Asystole and P wave asystole |ECG QRS complex |ECG ST segment |ECG: QT interval |ECG: LVH |ECG RVH |ECG: Bundle branch blocks |ECG Dominant R wave in V1 |ECG Acute Coronary Syndrome |ECG Crib sheets
📖 Definition
- ➡️ Right Axis Deviation (RAD): QRS axis between +90° and +180°.
- 📈 ECG pattern:
- Leads II, III, aVF ➝ QRS positive (dominant R waves).
- Lead I ➝ QRS negative (dominant S wave).
⚠️ Causes of Right Axis Deviation
- 👶 Normal in infancy (physiological RAD).
- 🫀 Ostium Secundum ASD ➝ RV volume overload.
- 🚪 Severe Pulmonary Stenosis ➝ RV pressure load.
- 🔷 Tetralogy of Fallot (congenital cyanotic CHD).
- ⚡ Right Bundle Branch Block (RBBB).
- 🌬️ RV Hypertrophy from chronic lung disease (e.g. COPD, cor pulmonale) or pulmonary embolism (PE).
💡 Teaching Pearl
Right axis deviation usually reflects RV strain or hypertrophy. In an adult, new RAD should raise suspicion of
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