Leftward paraclockwise transposition of the electrocardiographic axis suggests the possibility of biventricular (left ventricle, right ventricle) hypertrophy of the heart.
Changes in the electrocardiogram (ECG) are generally influenced by the anatomical location of the heart, changes in cardiac diseases, abnormalities in electrical conduction, age and body size.
When the electrocardiographic axis is in the range of -30° to -90°, it is called leftward deviation of the electrocardiographic axis, which may be seen in left ventricular hypertrophy and left anterior branch block. Cis-clockwise transposition is a downward shift of the waveform that normally appears on V3 or V4, which can be seen in right ventricular hypertrophy.
It should be noted, however, that such changes on the ECG can be seen in normal subjects and are not always an anatomical transposition of the heart, which can be further evaluated by Doppler echocardiography.
Doppler echocardiography may be used for further evaluation. If abnormalities are detected, it is advisable to seek medical attention in a regular hospital to avoid delays.