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Left axis deviation

MedGen UID:
534423
Concept ID:
C0232297
Finding
Synonyms: Electrical left axis deviation; LAD - Left axis deviation; Q Axis Left Axis Deviation
SNOMED CT: Left axis deviation (39732003); LAD - Left axis deviation (39732003)
 
HPO: HP:0033568

Definition

A kind of abnormal ventricular axis in the EKG whereby the QRS axis falls between -30 degrees and -90 degrees. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVLeft axis deviation

Conditions with this feature

Lethal congenital glycogen storage disease of heart
MedGen UID:
337919
Concept ID:
C1849813
Disease or Syndrome
A rare glycogen storage disease with fetal or neonatal onset of severe cardiomyopathy with non-lysosomal glycogen accumulation and fatal outcome in infancy. Patients present with massive cardiomegaly, severe cardiac and respiratory complications and failure to thrive. Non-specific facial dysmorphism, bilateral cataracts, macroglossia, hydrocephalus, enlarged kidneys and skeletal muscle involvement have been reported in some cases.
Cardiomyopathy, familial restrictive, 3
MedGen UID:
382807
Concept ID:
C2676271
Disease or Syndrome
Familial restrictive cardiomyopathy is a genetic form of heart disease. For the heart to beat normally, the heart (cardiac) muscle must contract and relax in a coordinated way. Oxygen-rich blood from the lungs travels first through the upper chambers of the heart (the atria), and then to the lower chambers of the heart (the ventricles).\n\nIn people with familial restrictive cardiomyopathy, the heart muscle is stiff and cannot fully relax after each contraction. Impaired muscle relaxation causes blood to back up in the atria and lungs, which reduces the amount of blood in the ventricles.\n\nFamilial restrictive cardiomyopathy can appear anytime from childhood to adulthood. The first signs and symptoms of this condition in children are failure to gain weight and grow at the expected rate (failure to thrive), extreme tiredness (fatigue), and fainting. Children who are severely affected may also have abnormal swelling or puffiness (edema), increased blood pressure, an enlarged liver, an abnormal buildup of fluid in the abdominal cavity (ascites), and lung congestion. Some children with familial restrictive cardiomyopathy do not have any obvious signs or symptoms, but they may die suddenly due to heart failure. Without treatment, the majority of affected children survive only a few years after they are diagnosed.\n\nAdults with familial restrictive cardiomyopathy typically first develop shortness of breath, fatigue, and a reduced ability to exercise. Some individuals have an irregular heart beat (arrhythmia) and may also experience a sensation of fluttering or pounding in the chest (palpitations) and dizziness. Abnormal blood clots are commonly seen in adults with this condition. Without treatment, approximately one-third of adults with familial restrictive cardiomyopathy do not survive more than five years after diagnosis.
Congenital heart defects, multiple types, 9
MedGen UID:
1841003
Concept ID:
C5830367
Congenital Abnormality
Multiple types of congenital heart defects-9 (CHTD9) is characterized by common arterial trunk (truncus arteriosus communis) in most patients, associated with other cardiac defects, including tetralogy of Fallot, interrupted aortic arch, right aortic arch, ventricular hypoplasia, and hypoplastic left heart, as well as other vascular and valvular anomalies (Ta-Shma et al., 2013; Guimier et al., 2023). For a general phenotypic description and discussion of genetic heterogeneity of multiple types of congenital heart defects, see CHTD1 (see 306955).

Professional guidelines

PubMed

Bacharova L, Chevalier P, Gorenek B, Jons C, Li YG, Locati ET, Maanja M, Pérez-Riera AR, Platonov PG, Ribeiro ALP, Schocken D, Soliman EZ, Svehlikova J, Tereshchenko LG, Ugander M, Varma N, Elena Z, Ikeda T
Ann Noninvasive Electrocardiol 2024 Jan;29(1):e13097. Epub 2023 Nov 24 doi: 10.1111/anec.13097. PMID: 37997698Free PMC Article
Halasz G, Cattaneo M, Piepoli M, Romano S, Biasini V, Menafoglio A, Gasperetti A, Badini M, Villa M, Dall'Ara L, Roberto M, Cassina T, Capelli B
Int J Cardiol 2021 Jul 15;335:40-46. Epub 2021 Apr 12 doi: 10.1016/j.ijcard.2021.04.019. PMID: 33857542
Zorzi A, Calore C, Vio R, Pelliccia A, Corrado D
Br J Sports Med 2018 May;52(10):667-673. Epub 2017 Jul 12 doi: 10.1136/bjsports-2016-097438. PMID: 28701362

Recent clinical studies

Etiology

Inoue N, Ogane T, Hiramatsu T, Morikawa S
J Electrocardiol 2023 Sep-Oct;80:119-124. Epub 2023 Jun 10 doi: 10.1016/j.jelectrocard.2023.06.002. PMID: 37327711
Ponnusamy SS, Vijayaraman P
J Cardiovasc Electrophysiol 2022 Feb;33(2):318-321. Epub 2021 Dec 23 doi: 10.1111/jce.15334. PMID: 34921478
Abu-Alrub S, Strik M, Huntjens P, Ramirez FD, Potse M, Cochet H, Marchand H, Buliard S, Eschalier R, Haïssaguerre M, Bordachar P, Ploux S
Heart Rhythm 2021 Aug;18(8):1352-1360. Epub 2021 Apr 6 doi: 10.1016/j.hrthm.2021.03.042. PMID: 33831543
Stein PD, Matta F, Ekkah M, Saleh T, Janjua M, Patel YR, Khadra H
Am J Cardiol 2012 Dec 15;110(12):1836-40. Epub 2012 Sep 21 doi: 10.1016/j.amjcard.2012.08.019. PMID: 23000104
MacKenzie R
J Insur Med 2005;37(3):227-32. PMID: 16259212

Diagnosis

Liu M, Lin Y, Qiao L, Chen J, Shi Q
Front Immunol 2023;14:1094611. Epub 2023 Feb 28 doi: 10.3389/fimmu.2023.1094611. PMID: 36926343Free PMC Article
Ponnusamy SS, Vijayaraman P
J Cardiovasc Electrophysiol 2022 Feb;33(2):318-321. Epub 2021 Dec 23 doi: 10.1111/jce.15334. PMID: 34921478
Stein PD, Matta F, Ekkah M, Saleh T, Janjua M, Patel YR, Khadra H
Am J Cardiol 2012 Dec 15;110(12):1836-40. Epub 2012 Sep 21 doi: 10.1016/j.amjcard.2012.08.019. PMID: 23000104
MacKenzie R
J Insur Med 2005;37(3):227-32. PMID: 16259212
Lancet 1976 Aug 28;2(7983):452-3. PMID: 73750

Therapy

Inoue N, Ogane T, Hiramatsu T, Morikawa S
J Electrocardiol 2023 Sep-Oct;80:119-124. Epub 2023 Jun 10 doi: 10.1016/j.jelectrocard.2023.06.002. PMID: 37327711
Ponnusamy SS, Vijayaraman P
J Cardiovasc Electrophysiol 2022 Feb;33(2):318-321. Epub 2021 Dec 23 doi: 10.1111/jce.15334. PMID: 34921478
Lui JK, Sangani RA, Chen CA, Bujor AM, Trojanowski MA, Gopal DM, LaValley MP, Soylemez Wiener R, Klings ES
Arthritis Care Res (Hoboken) 2022 Jul;74(7):1219-1226. Epub 2022 Apr 5 doi: 10.1002/acr.24724. PMID: 34085410Free PMC Article
van der Ree MH, Vendrik J, Kors JA, Amin AS, Wilde AAM, Tan HL, Postema PG
Int J Mol Sci 2021 Jan 6;22(2) doi: 10.3390/ijms22020484. PMID: 33418933Free PMC Article
Zhou G, Lu X, Nie Z, Chen S, Wei Y, Cai L, Xu J, Ding Y, Peng S, Wu X, Wang Z, Liu S
Europace 2020 Nov 1;22(11):1688-1696. doi: 10.1093/europace/euaa175. PMID: 32888292

Prognosis

Liu M, Lin Y, Qiao L, Chen J, Shi Q
Front Immunol 2023;14:1094611. Epub 2023 Feb 28 doi: 10.3389/fimmu.2023.1094611. PMID: 36926343Free PMC Article
Lui JK, Sangani RA, Chen CA, Bujor AM, Trojanowski MA, Gopal DM, LaValley MP, Soylemez Wiener R, Klings ES
Arthritis Care Res (Hoboken) 2022 Jul;74(7):1219-1226. Epub 2022 Apr 5 doi: 10.1002/acr.24724. PMID: 34085410Free PMC Article
Seko Y, Kato T, Yamaji Y, Haruna Y, Nakane E, Haruna T, Inoko M
Sci Rep 2021 Apr 26;11(1):8892. doi: 10.1038/s41598-021-88259-8. PMID: 33903653Free PMC Article
Storkås HS, Hansen TF, Tahri JB, Lauridsen TK, Olsen FJ, Borgquist R, Vinther M, Lindhardt TB, Bruun NE, Søgaard P, Risum N
J Electrocardiol 2020 Nov-Dec;63:147-152. Epub 2019 Apr 5 doi: 10.1016/j.jelectrocard.2019.04.007. PMID: 31003852
Lehtonen AO, Puukka P, Varis J, Porthan K, Tikkanen JT, Nieminen MS, Huikuri HV, Anttila I, Nikus K, Kähönen M, Jula A, Niiranen TJ
J Hypertens 2016 May;34(5):959-66. doi: 10.1097/HJH.0000000000000882. PMID: 26886566

Clinical prediction guides

Lui JK, Sangani RA, Chen CA, Bujor AM, Trojanowski MA, Gopal DM, LaValley MP, Soylemez Wiener R, Klings ES
Arthritis Care Res (Hoboken) 2022 Jul;74(7):1219-1226. Epub 2022 Apr 5 doi: 10.1002/acr.24724. PMID: 34085410Free PMC Article
Zhou G, Lu X, Nie Z, Chen S, Wei Y, Cai L, Xu J, Ding Y, Peng S, Wu X, Wang Z, Liu S
Europace 2020 Nov 1;22(11):1688-1696. doi: 10.1093/europace/euaa175. PMID: 32888292
Storkås HS, Hansen TF, Tahri JB, Lauridsen TK, Olsen FJ, Borgquist R, Vinther M, Lindhardt TB, Bruun NE, Søgaard P, Risum N
J Electrocardiol 2020 Nov-Dec;63:147-152. Epub 2019 Apr 5 doi: 10.1016/j.jelectrocard.2019.04.007. PMID: 31003852
Chou FS, Johnson AJ, Ghimire LV
Pediatr Cardiol 2019 Apr;40(4):677-684. Epub 2019 Mar 16 doi: 10.1007/s00246-019-02086-3. PMID: 30879085
Stein PD, Matta F, Ekkah M, Saleh T, Janjua M, Patel YR, Khadra H
Am J Cardiol 2012 Dec 15;110(12):1836-40. Epub 2012 Sep 21 doi: 10.1016/j.amjcard.2012.08.019. PMID: 23000104

Recent systematic reviews

Chou FS, Johnson AJ, Ghimire LV
Pediatr Cardiol 2019 Apr;40(4):677-684. Epub 2019 Mar 16 doi: 10.1007/s00246-019-02086-3. PMID: 30879085

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