Poor r wave progression

• • • • • • • Frequent • Ventricular dysrhythmias ( • The most common ECG abnormalities are those associated with atrial and ventricular hypertrophy — typically, left-sided changes are seen but there may be signs of biatrial or biventricular hypertrophy • Interventricular conduction delays (e.g. LBBB) occur due to cardiac dilatation • Diffuse myocardial fibrosis may lead to reduced voltage QRS complexes, particularly in the limb leads. There may be a discrepancy of QRS voltages with signs of hypertrophy in V4-6 and relatively low voltages in the limb leads • Abnormal Q waves are most often seen in leads V1 to V4 and may mimic the appearance of a myocardial infarction (“pseudoinfarction” pattern) Dilated Cardiomyopathy Overview Dilated cardiomyopathy (DCM) is a myocardial disease characterised by ventricular dilatation and global myocardial dysfunction (ejection fraction < 40%). • Patients usually present with symptoms of biventricular failure, e.g. fatigue, dyspnoea, orthopnoea, ankle oedema • Associated with a high mortality (2-year survival = 50%) due to progressive cardiogenic shock or ventricular dysrhythmias (sudden cardiac death) Ischaemic dilated cardiomyopathy: • There is marked • Right axis deviation suggests associated right ventricular hypertrophy (i.e. • There is evidence of • There are peaked P waves in lead II suggestive of This patient had four-chamber dilatation on echocardiography with severe congestive cardiac failure (awaiting cardiac transplantation). I...

PRWP indicates possible prior anterior myocardial infarction (MI); however, it is observed frequently in apparently normal individuals. In contrast, reversed R wave progression (RRWP), which occurs in as many as 2% of all hospitalized patients, may be more specific to cardiac disorders 2 ). How common is poor R wave progression? Contents • How common is poor R wave progression? • Can poor R wave progression be normal? • What does R wave progression indicate? • What is good R wave progression? • What does R wave represent? • What does anterior myocardial infarction mean? • What does poor R wave progression V3 mean? • What causes inverted R waves? • What is the R wave indicative of an ECG? • Is a sinus rhythm good? • What is abnormal ECG? • What does ST depression indicate? • How tall should R wave be? • Is anterior infarct serious? • How is an anterior myocardial infarction treated? • What does a notched R wave mean? • Is depolarization a contraction? • Is the R wave always positive? • Which lead usually has the largest R wave? • Which leads are used to compare R waves? • What causes the S wave? Based on the commonly used criteria in practice (R-wave in V3 or V4 ≤2 mm), the prevalence of PRWP in the general population was 1.8% (372/20,739), and based on the Marquette system it was 0.5% (96/20,739). Can poor R wave progression be normal? Electrocardiographic poor R wave progression (PRWR) is found in patients with anterior myocardial infarction, left ventricular hypertrophy ...

PRWP indicates possible prior anterior myocardial infarction (MI); however, it is observed frequently in apparently normal individuals. In contrast, reversed R wave progression (RRWP), which occurs in as many as 2% of all hospitalized patients, may be more specific to cardiac disorders 2 ). How common is poor R wave progression? Contents • How common is poor R wave progression? • Can poor R wave progression be normal? • What does R wave progression indicate? • What is good R wave progression? • What does R wave represent? • What does anterior myocardial infarction mean? • What does poor R wave progression V3 mean? • What causes inverted R waves? • What is the R wave indicative of an ECG? • Is a sinus rhythm good? • What is abnormal ECG? • What does ST depression indicate? • How tall should R wave be? • Is anterior infarct serious? • How is an anterior myocardial infarction treated? • What does a notched R wave mean? • Is depolarization a contraction? • Is the R wave always positive? • Which lead usually has the largest R wave? • Which leads are used to compare R waves? • What causes the S wave? Based on the commonly used criteria in practice (R-wave in V3 or V4 ≤2 mm), the prevalence of PRWP in the general population was 1.8% (372/20,739), and based on the Marquette system it was 0.5% (96/20,739). Can poor R wave progression be normal? Electrocardiographic poor R wave progression (PRWR) is found in patients with anterior myocardial infarction, left ventricular hypertrophy ...

• • • • • • • Frequent • Ventricular dysrhythmias ( • The most common ECG abnormalities are those associated with atrial and ventricular hypertrophy — typically, left-sided changes are seen but there may be signs of biatrial or biventricular hypertrophy • Interventricular conduction delays (e.g. LBBB) occur due to cardiac dilatation • Diffuse myocardial fibrosis may lead to reduced voltage QRS complexes, particularly in the limb leads. There may be a discrepancy of QRS voltages with signs of hypertrophy in V4-6 and relatively low voltages in the limb leads • Abnormal Q waves are most often seen in leads V1 to V4 and may mimic the appearance of a myocardial infarction (“pseudoinfarction” pattern) Dilated Cardiomyopathy Overview Dilated cardiomyopathy (DCM) is a myocardial disease characterised by ventricular dilatation and global myocardial dysfunction (ejection fraction < 40%). • Patients usually present with symptoms of biventricular failure, e.g. fatigue, dyspnoea, orthopnoea, ankle oedema • Associated with a high mortality (2-year survival = 50%) due to progressive cardiogenic shock or ventricular dysrhythmias (sudden cardiac death) Ischaemic dilated cardiomyopathy: • There is marked • Right axis deviation suggests associated right ventricular hypertrophy (i.e. • There is evidence of • There are peaked P waves in lead II suggestive of This patient had four-chamber dilatation on echocardiography with severe congestive cardiac failure (awaiting cardiac transplantation). I...