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Left axis deviation and tall R waves in the electrocardiogram

Z Duraković, M Mimica

    Journal of Electrocardiology
    |January 1, 1981
    PubMed
    Summary

    Left axis deviation and tall R waves on ECGs are more common in men and older individuals. These findings are linked to hypertension and potential myocardial ischemia, though tall R waves show dynamic changes.

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    Area of Science:

    • Cardiology
    • Electrocardiography
    • Public Health

    Background:

    • Electrocardiogram (ECG) findings like left axis deviation and tall R waves are assessed using the Minnesota Code.
    • Prevalence and associations of these ECG markers in a large adult population are not fully elucidated.

    Purpose of the Study:

    • To investigate the prevalence and characteristics of left axis deviation and tall R waves (left type) in a population sample.
    • To explore associations between these ECG findings and demographic factors, hypertension, and indicators of myocardial ischemia.

    Main Methods:

    • Analysis of ECGs from 4210 subjects aged 35-54, assessed twice over three years.
    • Categorization of ECG findings according to the Minnesota Code.
    • Statistical analysis to determine prevalence, demographic correlations, and associations with hypertension and ischemic changes.

    Main Results:

    • Left axis deviation observed in 2.9% and tall R waves in 2.2% of subjects.
    • Both findings were more prevalent in men and older individuals within the study cohort.
    • Significant association found between both ECG abnormalities and combined diastolic-systolic hypertension.
    • Tall R waves were linked to S-T segment and T wave changes, but 66% lacked these, and persistence was observed in only one-third, suggesting myocardial dynamics.

    Conclusions:

    • Left axis deviation and tall R waves are notable ECG findings associated with hypertension in middle-aged adults.
    • The dynamic nature of tall R waves highlights myocardial variability, and their association with ischemia warrants further investigation.

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