Poor R Wave Progression: Difference between revisions
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==Definition== | ==Definition== | ||
The definition of | 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== | ||
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Synonyms and keywords: Poor R wave transition, delayed R wave transition, delayed transition
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 can be observed in the following settings:
- Faulty ECG recording technique
- Left bundle branch block
- Myocardial infarction
- Right and left ventricular hypertrophy
- Wolff–Parkinson–White syndrome
References
- ↑ Poor R-Wave Progression. By: Ross MacKenzie, MD. J Insur Med 2005;37:58–62