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June 1982

ECG Poor R-Wave Progression: Review and Synthesis

Author Affiliations

From the Department of Cardiology, Brookhaven Memorial Hospital Medical Center, Patchogue, NY (Dr Zema); and Division of Cardiology, Department of Medicine, The New York Hospital-Cornell Medical Center, New York (Dr Kligfield).

Arch Intern Med. 1982;142(6):1145-1148. doi:10.1001/archinte.1982.00340190101018

• Poor R-wave progression is a common ECG finding that is often inconclusively interpreted as suggestive, but not diagnostic, of anterior myocardial infarction (AMI). 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. An interpretive approach to the ECG with poor R-wave progression is presented that has clinical relevance in the daily treatment of patients.

(Arch Intern Med 1982;142:1145-1148)