| Physiologic or positional factors |
| Misplacement of chest leads |
| Normal variants |
| Displacement of heart toward right chest (dextroversion) - congenital or acquired |
| Myocardial injury |
| Posterior and/or lateral MI myocardial infarction |
| Duchenne muscular dystrophy |
| Ventricular enlargement |
| Right ventricular hypertrophy (usually with right axis deviation) |
| Hypertrophic cardiomyopathy |
| Altered ventricular depolarization |
| Right ventricular conduction abnormalities |
| Wolff-Parkinson-White patterns (due to posterior or lateral wall preexcitation) |
