Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: resting ECG results
Forum: The Heart Forum
Topic Area: Electrocard
Posted by CCF CARDIO MD - DLB on February 02, 1999 at 16:51:48:
In Reply to: resting ECG results posted by bnt on February 01, 1999 at 20:56:28:


I am a 40 year old female with a history of hypertension dating back to the age of 24. I have been on several meds,each of which has had some effect in reducing my BP but has worked consistently. My average BP is 140/92, on meds. I have had a history of chest tightness and palpitations off and on for the past 3 years. Previous doctors attributed it sstress
and did no tests. I just changed MDs and a stress test ,echo(for heart murmur)and 24 hr Holter were ordered. Results: Echo normal. Holter-sinus tachycardia. Stress- Resting ECG showed normal sinus rhtyum, rightward axis and poor R wave progression. Per Bruce protocal I lasted 6 min. until stopped due to BP
of 220/118 and SOB. No chest pain. Random PVCs. ST upsloping depression 0.5mm. Whatis poor R wave progression and do any further studies need to be ordered? Palpitations and chest pressure continue.THANKS!

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Dear bnt

Poor R wave progression is a finding on an EKG that can reflect either an artifact of the way that the EKG leads are placed or reflect a previous heart attack. It is unlikely to represent an old heart attack, given that your echo was normal. However, your symptoms could still be from coronary artery disease; the only way to know for sure would be a cardiac catheterization. The stress test was terminated too early (though appropriately) to be definitive.

I hope this has been useful. I wish you the best of luck. Feel free to write back.

Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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