Other ECG changes in ischemia and infarction
Pathological R-wave progression Normal R-wave progression implies that the R-wave amplitude increases gradually from V1 to V5 and then diminishes again in V6. Refer to Figure 1 . Abnormal R-wave progression implies that the gradual increase from V1 to V5 is absent. It may be broken, as in Figure 1 . Any type of infarction may cause pathological R-wave progression. However, the specificity for pathological R-wave progression is considerably lower than pathological Q-waves and guidelines do not state any ECG criteria specific to R-wave progression. Figure 1. Pathological R-wave progression is indicative of previous myocardial infarction . U-wave changes New U-waves (in absence of bradycardia ) may indicate ischemia. If U-waves were present on previous recording, the amplitude must be increased in order to suggest ischemia. Inverted U-waves are even more typical of ischemia (but the sensitivity is low). U-wave changes always accompany other ischemic ST-T changes. They may occur in both NSTEMI an…
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