Test Findings
 

Poor R Wave Progression

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Overview

  • Poor R wave progression is classically suggestive of anterior MI, though may occur in certain other conditions.
    • Look For

    • Gradual change in the direction of the QRS complex from negative to positive across the chest leads, generally with peak R wave height in V4 that tapers off over V5 and V6.
    • Normal R wave progression:
    • Normal R wave progression
    • Poor R wave progression: 
    • Poor R wave progression 
    • Causes of Poor R Wave Progression

    • Normal variant
    • Anterior myocardial infarction
    • Left ventricular hypertrophy
    • Right ventricular hypertrophy
    • Incorrect chest lead placement
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