Poor R wave progression across the precordium refers to an electrocardiographic finding where the normal increase in R wave amplitude as one progresses from V1 to V6 is lost. Although non-specific, this finding is consistent with a prior anterior myocardial infarction.Oct 19, 2012
Poor R wave progression refers to the absence of the normal increase in size of the R wave in the precordial leads when advancing from lead V1 to V6. In lead V1, the R wave should be small. The R wave becomes larger throughout the precordial leads, to the point where the R wave is…
Recent studies have shown that poor R-wave progression has the following four distinct major causes: AMI, left ventricular hypertrophy, right ventricular hypertrophy, and a variant of normal with diminished anterior forces. Standard ECG criteria that identify and distinguish these causes have been developed.
Tall R waves in V1 can be caused by abnormal electrical conduction (RBBB or left-sided VT, which slowly spreads across the right ventricle, or a left-sided accessory pathway), loss of posterior myocardium (old or acute posterior MI) or chronic anterior hypertrophy (HCM), chronic or acute RV strain (RVH, PE), congenital Nov 10, 2020
The causes for a R/S wave ratio greater than 1 in lead V1 include right bundle branch block, Wolff-Parkinson-White syndrome, an acute posterior myocardial infarction, right ventricular hypertrophy and isolated posterior wall hypertrophy, which can occur in Duchenne muscular dystrophy.