Poor R Wave Progression: Difference between revisions
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==Definition== | ==Definition== | ||
The definition of ''poor R wave progression'' (PRWP) varies in the literature, but a common one is when the R wave is less than 2–4 mm in leads V<sub>3</sub> or V<sub>4</sub> and/or there is presence of a reversed R wave progression, which is defined as R in V<sub>4</sub> < R in V<sub>3</sub> or R in V<sub>3</sub> < R in V<sub>2</sub> or R in V<sub>2</sub> < R in V<sub>1</sub>, or any combination of these.<ref | The definition of ''poor R wave progression'' (PRWP) varies in the literature, but a common one is when the R wave is less than 2–4 mm in leads V<sub>3</sub> or V<sub>4</sub> and/or there is presence of a reversed R wave progression, which is defined as R in V<sub>4</sub> < R in V<sub>3</sub> or R in V<sub>3</sub> < R in V<sub>2</sub> or R in V<sub>2</sub> < R in V<sub>1</sub>, or any combination of these.<ref>Poor R-Wave Progression. By: Ross MacKenzie, MD. J Insur Med 2005;37:58–62</ref> | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 20:17, 1 April 2012
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Overview
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.
Definition
The definition of poor R wave progression (PRWP) varies in the literature, but a common one is when the R wave is less than 2–4 mm in leads V3 or V4 and/or there is presence of a reversed R wave progression, which is defined as R in V4 < R in V3 or R in V3 < R in V2 or R in V2 < R in V1, or any combination of these.[1]
Differential Diagnosis
Poor R wave progression is commonly attributed to anterior myocardial infarction, but it may also be caused by left bundle branch block, Wolff–Parkinson–White syndrome, right and left ventricular hypertrophy as well as by faulty ECG recording technique.[2]