17 hrs confidence:   loss of R-wave height/loss of R-wave voltage/loss of R-wave progression
Explanation:
Reversed R wave progression (RRWP):
Reversed R wave progression is defined as a loss of R wave height between leads V I and V2 or between leads V2 and V3 or between leads V3 and V4. In the absence of LVH, this finding suggests anterior MI or precordial lead reversal.
http://medicine.ucsf.edu/education/resed/ecg/r_waves.html
The abnormalities you should look for are: “significant” Q waves, loss of precordial R height, ST elevation in contiguous leads, and T wave peaking or inversion. Any combination of these abnormalities can be present during the evolution of infarction.
http://www.madsci.com/manu/ekg_mi.htm
As the acute myocardial infarction evolves, changes to the QRS complex include loss of R wave height and the development of pathological Q waves.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122768/
Prognostic value of Q waves, R/S ratio, loss of R wave voltage, ST-T segment abnormalities, electrical axis, low voltage and notching: correlation of electrocardiogram and left ventriculogram
Loss of R wave voltage had a lower predictive value for segmental asynergy than did Q waves in the same lead.
http://content.onlinejacc.org/cgi/content/abstract/4/1/17
Loss of R-wave progression may occur with acute myocardial infarction, but this feature is not present with acute pericarditis.
http://www.aafp.org/afp/980215ap/marinell.html
This loss of R wave progression in COPD may in part reflect right ventricular dilation. In addition, downward displacement of the heart in the emphysematous chest may play a major role in the genesis of poor R wave progression in some cases. Partial or complete normalization of R wave progression in this setting can often be achieved simply by recording the chest leads an interspace lower than usual. In contrast, Q waves due to infarction are not altered by this change in lead position.
http://cmbi.bjmu.edu.cn/uptodate/electrocardiography/General...
| Ingrid Moore
Local time: 22:13
Specializes in field
Native speaker of: German
PRO pts in category: 32
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17 hrs confidence: peer agreement (net): +2 loss of R waves or poor R wave progression
Explanation:
http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson9/index...
7. Miscellaneous Abnormalities of the QRS Complex:
The differential diagnosis of these QRS abnormalities depend on other ECG findings as well as clinical patient information
Poor R Wave Progression - defined as loss of, or no R waves in leads V1-3 (R £2mm):
| SJLD
Local time: 22:13
Specializes in field
Native speaker of:  English
PRO pts in category: 108
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