What does a tall R wave mean?

Tall R waves in V1 can be caused by abnormal electrical conduction (RBBB or left-sided VT, which slowly spreads across the right ventricle, or a left-sided accessory pathway), loss of posterior myocardium (old or acute posterior MI) or chronic anterior hypertrophy (HCM), chronic or acute RV strain (RVH, PE), congenital …

What does the R wave represent?

These waves indicate the changing direction of the electrical stimulus as it passes through the heart’s conduction system. The largest wave in the QRS complex is the R wave. As you can see from the diagram, the R wave represents the electrical stimulus as it passes through the main portion of the ventricular walls.

What might cause an abnormally large tall QRS complex?

Tall QRS complexes are usually caused by hypertrophy of one or both ventricles, or by an abnormal pacemaker or aberrantly conducted beat. Low voltage or abnormally small QRS complexes may be seen in obese patients, hyperthyroid patients and pleural effusion.

What is the normal R wave and S wave progression across the chest?

Normally, in lead V1, there is a small R wave with a deep S wave; the R-wave amplitude should increase in size with the transition zone, normally in leads V2 to V4. Poor or late R-wave progression consists of a transition zone in lead V5 or V6, and it can be a sign of a previous anterior myocardial infarction.

Is atrial flutter a narrow complex tachycardia?

Atrial flutter: This is the only narrow complex tachycardia that appears in both the regular and irregular rhythm columns.

What causes high R waves?

The most common cause of a dominant R wave in aVR is incorrect limb lead placement, with reversal of the left and right arm electrodes. This produces a similar pattern to dextrocardia in the limb leads but with normal R-wave progression in the chest leads.

What does a small R wave mean?

What is QRS complex and what is its significance?

A combination of the Q wave, R wave and S wave, the “QRS complex” represents ventricular depolarization. This term can be confusing, as not all ECG leads contain all three of these waves; yet a “QRS complex” is said to be present regardless.

How tall should R wave be?

R-wave should be < 26 mm in V5 and V6. R-wave amplitude in V5 + S-wave amplitude in V1 should be <35 mm. R-wave amplitude in V6 + S-wave amplitude in V1 should be <35 mm. R-wave amplitude in aVL should be ≤ 12 mm.