What is poor R wave progression?

As a medical professional with expertise in cardiology, I can provide you with an explanation of poor R-wave progression. Poor R-wave progression is a term used to describe a specific pattern observed on an electrocardiogram (ECG). It refers to a situation where the R wave, which represents the ventricular depolarization in the heart, does not increase in amplitude as expected as you move across successive leads on the ECG. Normally, as you move from lead to lead, the R wave should grow larger, reflecting the spread of electrical activity through the heart. When this doesn't happen, it can indicate an issue with the heart's muscle or electrical conduction system. In the context of an ECG, poor R-wave progression is often inconclusively interpreted as suggestive, but not diagnostic, of anterior myocardial infarction (AMI), which is a type of heart attack affecting the front part of the heart. However, it can also be seen in other conditions such as left ventricular hypertrophy (LVH), bundle branch block, or even in healthy individuals. An interpretive approach to the ECG with poor R-wave progression is important for clinicians as it can provide valuable insights into the patient's cardiac condition. It's crucial to consider the ECG findings within the broader clinical context, including the patient's symptoms, medical history, and other diagnostic tests.

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