STAT ECG Diagnoses: the right way to think about right axis deviation

ECG Weekly Workout with Dr. Amal Mattu


A 91-year-old woman with PMHx of HTN, aortic stenosis, and dementia is brought to the ED by EMS after a syncopal episode when walking to the bathroom. Vital signs are normal, and exam is unremarkable aside from a notable systolic murmur. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the rhythm?
  3. What is the most likely cause of the abnormal axis?