Right axis deviation is seen in all except –a) VSDb) Tricuspid atresiac) Pulmonary atresiad) ASD

Normally, the QRS axis ranges from -30° to + 100°. An axis more negative than -30° is referred to as left axis deviation. An axis more positive than + 100° is referred to as right axis deviation. Causes of left axis deviation (LAD) Left ventricular hypertrophy Left anterior fascicular block or hemiblock. Inferior wall MI. Causes of Right axis deviation (RAD) Right ventricle overload (right ventricular hypertrophy Left posterior fascicular block. Lateral wall MI Dextrocardia Left pneumothorax Now see the explanations of the previous question and you can easily solve this question. Left ventricular hypertrophy causes LAD, and CHDs causing LVH are : - 1) VSD             iii) Endocardial cushion ASD            v) Truncus arteriosus           ii) PDA             iv) COA (in older children)                 vi) Tricuspid atresia vii) Pulmonary atresia Right ventricular hypertrophy causes RAD, and CHD's causing RVH are : - TGA                                                                      TAPVR    TOF ASD      Eisenmenger's syndrome          COA (in infants)                           About option 'a' All patients with VSD are born with right ventricular hypertrophy, as the pulmonary vascular resistance decreases, RVH regresses and there is LVH. Hemodynamics of VSD will be explained in the respective question. So, at birth VSD may show right axis deviation.