What does poor R wave progression mean?

As a medical professional with expertise in cardiology, I can explain what "poor R wave progression" means in the context of an electrocardiogram (ECG or EKG) reading. Poor R wave progression refers to a specific finding on an ECG that indicates the electrical activity of the heart is not following the expected pattern as it travels down the ventricles. Normally, as the electrical impulse travels through the ventricles, the R wave, which represents ventricular depolarization, should increase in amplitude from one lead to the next in a sequential manner. This is particularly observed in the precordial leads (V1 to V6), which are positioned across the chest to view the heart from different angles. When there is poor R wave progression, the R wave does not increase in size as it should, or it may even decrease. This can be a sign of various cardiac conditions, including: 1. Coronary artery disease (CAD): Narrowing of the arteries can lead to changes in the ECG. 2. **Prior myocardial infarction (heart attack)**: Damage to the heart muscle can alter the ECG pattern. 3. Left ventricular hypertrophy (LVH): Enlargement of the heart muscle can affect the ECG readings. 4. Cardiomyopathy: A disease of the heart muscle that can also lead to changes in the ECG. 5. Conduction abnormalities: Issues with the heart's electrical conduction system can cause variations in the ECG. It's important to note that poor R wave progression is not a diagnosis in itself but rather a clue that prompts further investigation. A healthcare provider will consider the patient's symptoms, medical history, physical examination, and other diagnostic tests to determine the underlying cause.

Poor R-wave progression (PRWP) is a common ECG finding that is often inconclusively interpreted as suggestive, but not diagnostic, of anterior myocardial infarction (AMI). PRWP is defined by: R wave height �� 3 mm in V3.