There aren't many abnormalities that result in this significant of a right axis in an adult. They include right ventricular hypertrophy (RVH), left posterior fascicular block and dextrocardia, amongst others.

The remainder of the clues are in Leads V1 and V6.

The tall R-wave in V1 and the persistent S-wave in V6, along with right axis deviation indicate the presence of RVH. (The ST and T abnormalities can all be secondary to the RVH.)