Sorry, should be:

Marked left axis deviation (in ECG).

Linkstyp = left axis deviation.

Actually, John, I don’t think it’s that simple -- you first of all have to define your terms.

With a "Linkstyp" the cardiac axis lies between -30° and +30°
"Der Linkstyp oder Horizontaltyp ist ein Lagetyp des Herzens, bei dem die elektrische Herzachse in der Frontalebene einen Winkel zwischen -30° und +30° aufweist."
http://flexikon.doccheck.com/Linkstyp
 
"Überdrehte Linkslage ["Überdrehter Linkstyp"]: Der QRS-Vektor weist über -30° hinaus"
http://books.google.ch/books?id=wHVb-ixm5xQC...

It depends, therefore, how you define a “normal axis”, “left axis deviation” and “marked/extreme left axis deviation” in English – and that’s not 100% clear cut. You find statements such as “By near-consensus, the normal QRS axis is defined as ranging from -30° to +90°”

From the BMJ:
"The normal range for the cardiac axis is between -30° and +90°. An axis lying beyond -30° is termed left axis deviation, whereas an axis >90° is termed right axis deviation.
http://www.bmj.com/cgi/content/full/324/7334/...

And from the Alan E. Lindsay ECG Learning Center:
“In the diagram below the normal range is identified (-30° to +90°).
Left axis deviation (i.e., superior and leftward) is defined from -30° to -90°, and right axis deviation (i.e., inferior and rightward) is defined from +90° to +150°.”
http://library.med.utah.edu/kw/ecg/ecg_outlin...

"A normal heart axis is between -30 and +90 degrees.
http://en.ecgpedia.org/wiki/Heart_axis

For left axis deviation:
"As a result, the mean electrical axis is extremely leftward, defined as an axis that is greater than -45º or -60º depending upon the author."
http://heartnet.bjmu.edu.cn/clinic/uptodate/e...

"… with marked left axis deviation, usually minus 60 degrees"
http://www.madsci.com/manu/ekg_blok.htm

So, by the above definitions, Linkstyp (-30° to +30°) falls within the normal range, while überdrehte Linkslage/überdrehter Linkstyp is left axis deviation to the left of -30° and also marked LAD to the left of -45°/-60° or greater (depending on the author).

However, if you take a different definition, e.g.:

“We should call an axis between 0° and -30° a left axis deviation and an axis more leftward than -30° a marked left axis deviation.
Note: There are many cardiologists who consider up to -30° normal. We have been unable to confirm this in the absence of an RBBB pattern
http://books.google.ch/books?id=VvAHDBrgO_gC...

"Left axis deviation up to -30° can be normal. If there is left axis deviation look at lead aVL. If aVL is predominantly negative the axis is less than 30° and normal. If it is predominantly positive the axis is greater than 30° and there is significant left axis deviation."
http://www.patient.co.uk/reference/ECG_A_Meth...

then “Linkstyp” may indeed be translated as “left axis deviation” and “uberdrehter Linkstyp” as “marked left axis deviation” …

“Extreme axis deviation” is often used for values in the north-west territory …

However, there is also the term “horizontal heart” in English which covers both the “Querlage”/ “Quertyp” (O° to + 30°) and the "Linkslage"(-30 to 0°) of some authors and meets the usual definition of "Linkstyp" (-30° to +30°) exactly:

Online medical dictionary:
Horizontal heart, description of the heart's electrical position; recognised in the electrocardiogram when the QRS in lead aVL resembles that in V6 and QRS in aVF resembles that in V1; also, loosely, when the electrical axis lies between -30° and +30°.
http://www.mondofacto.com/facts/dictionary?Ho...

In many cases, it is safest to give the range for "Linkstyp"… “cardiac axis between -30° and +30°” or call it a "horizontal heart".

Linkstyp = horizontal heart
Überdrehter Linkstyp = left axis deviation

OK, thanks, Marianne.

But what if all you have is a (Swiss) hospital report, saying

KSM (=carotid sinus massage??): normal SR, üLLT, no de/repolarisation disorders?

Firstly, is üLLT a typo? (Wouldn't be the first one, even from the land of precision watches). And secondly, how do you translate it in the absence of further info?

üLLT = überdrehter Linkslagetyp = überdrehter Linkstyp

Hi John
gygis beat me to it with the abbreviation ;-)

"The normal range for the cardiac axis is between -30° and 90°. An axis lying beyond -30° is termed left axis deviation, whereas an axis >90° is termed right axis deviation." (see link above, BMJ)
IAN a cardiologist, but this agrees with what I was taught, so - to me - a cardiac axis between -30° and +30° ("Linkstyp") is normal and, as I said above, I would translate it as "horizontal heart" and definitely not as "left axis deviation".

üL(L)T -> über -30° hinaus
check with the link here, which shows (-30° to -90°):
http://flexikon.doccheck.com/Linkstyp
or here:
http://www.lob.de/pdf/3865410111.pdf
so, without any more detail, I would call it "left axis deviation".

If you start calling it "marked" LAD (which is anyway not a clearly defined term in standard reference texts), you would be pushing the axis to -60° or beyond, which may or may not be the case. All you can tell from the German is that it is leftward of -30°.
http://flexikon.doccheck.com/Linkstyp

(On the other hand, "Rechtstyp" (90° to 120°) is never within normal limits => right axis deviation, and so you can call üRT "marked" RAD because it's definitely beyond 120°...)


Why the carotid sinus massage? - tachyarrhythmia? diagnosis of syncope? not something you do without good reason.

(not Kantonsspital Münsterlingen? ;-)