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Review and Synthesis

Michael J. Zema, MD; Paul Kligfield, MD

Arch Intern Med. 1982;142(6):1145-1148.

Abstract
• 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)

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).

Footnotes
Accepted for publication Feb 24, 1982.

Reprint requests to Director of Cardiology, Brookhaven Memorial Hospital Medical Center, 101 Hospital Rd, Patchogue, NY 11772 (Dr Zema).

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