Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would like to explain that a poor anterior R wave progression has several explanations as follows:

- a chronic pulmonary disorder which may lead to right heart enlargement and displacement of the normal cardiac electrical axis in the horizontal plain (and poor anterior R wave progression);

- poor anterior R wave progression may be seen in certain healthy individuals as a result of their geometric thorax construction (especially in round thorax pattern);

- in the presence of cardiac inter-ventricular septum hypertrophy sometimes there exists poor anterior R wave progression;

- anterior myocardial infarction may be expressed with anterior R wave amputation and poor R wave progression, but this pattern is not diagnostic of cardiac ischemia and other specific features like previous chest pain, wall motion abnormalities on cardiac ultrasound, etc. should be present to raise sufficient suspicions for myocardial infarction alternative;

- some cardiac disorders, like dilated cardiomyopathy, myocarditis, etc. may be associated with poor anterior R wave progression; but in such cases a specific clinical scenario should be almost always present. etc.

So, coming to this point, what i would like to emphasize is the fact that a certain ECG findings could not be sufficient to raise so much fear or suspicions for myocardial infarction. Resting ECG may only confirm or support medical findings from other cardiac or medical tests.

I recommend consulting with your doctor (internist or cardiologist) on the above mentioned issues and see the opportunity of performing some additional tests like:

- cardiac ultrasound,
- chest X ray study,
- cardiac enzumes (CK-MB, Troponin),
- pulmonary function tests if necessary, etc.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri

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