There is Left Axis Deviation
- There are small Q waves with tall R waves in Lead I and aVL
- There are small R waves with deep S waves in leads II, III and aVF
- QRS duration should be essentially normal:
the fascicle blocks affect the direction but not the duration of the QRS
- R wave peak time is prolonged (over 45msec)
- Limb lead QRS voltage should be increased
in summary...
- Might just be a normal consequence of ageing
- …or, it could be severe LAD disease
- Its common after aortic valve surgery
From "the ECG made easy", by Hampton (2003), and ECGs shamelessly stolen from Life in The Fastlane without any sort of permission, but in the non-commercial spirit of free education
2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines