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A patient with non-Q wave myocardial infarction had severe luminal narrowing in the first major septal perforator branch, which arose anomalously from the first diagonal branch. In this case, an exercise ECG showed a transient leftward QRS axis shift.

circulation journal

Ischemia in the Territory of the First Major Septal Perforator Branch Anomalously Originating From the First Diagonal Branch Leads to a Transient Leftward Shift of the QRS Axis in the Frontal Plane-A Case Report-