119

International Journal of Cardiology, 34 (1992) 119

0 1992 Elsevier Science Publishers B.V. All rights reserved 0167-5273/92/$05.00 CARD10 01406

Letter to the Editor

Left axis deviation in children Sir,

1 May 1990

Calcaterra and Puglisi reported in the Journal that 14 of 1036 (1.4%) electrocardiograms recorded from children without current evidence of heart disease had mean frontal plane QRS axes of -30 degrees or less [l]. Interestingly, 13 (93%) of their patients with left axis deviation were male. We performed a similar study on 779 healthy adolescents between 10 and 19 years of age [2]. Only three (0.4%) of our patients had mean frontal QRS axes of -30 degrees of less (males 12 and 15 years old, and a 12-year-old female). Part of the reason that left axis deviation occurred less frequently in our study may be that we excluded patients with a history of heart diseaser. Three of the patients of Calcaterra and Puglisi with left axis deviation had had a spontaneously closed ventricular septal defect. It is well known that a superior QRS axis may be associated with a ventricular septal defect [3].

We are in agreement with the principal conclusion of Calcaterra and Puglisi, that children without heart disease may have left axis deviation. In the absence of other abnormalities on either the physical examination or the electrocardiogram, left axis deviation in children does not warrant further evaluation. William Beaumont Army Medical Center El Paso, TX 79920 U.S.A.

Elizabeth

William Pearl M. Stafford

1 Calcaterra G, Puglisi R. Left axis deviation in healthy infants and children. Int J Cardiol 1989;24:236-238. 2 Pearl W, Stafford EM, Weir MR, Gregory G, Imai W, Schydlower M. Electrocardiogram value in routine adolescent physical examinations. Int Pediatr 1987;2:342-344. 3 Shaw NJ, Godman MJ, Hayes A, Sutherland GR. Superior QRS axis in ventricular septal defect. Br Heart J 1989;62:281-283.

Left axis deviation in children.

119 International Journal of Cardiology, 34 (1992) 119 0 1992 Elsevier Science Publishers B.V. All rights reserved 0167-5273/92/$05.00 CARD10 01406...
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