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10 Possible Causes for Dull Chest Pain, Poor R Wave Progression, Pulmonary Systolic Murmur

  • Pulmonary Embolism

    Main symptoms of a pulmonary embolism include chest pain that may be any of the following: Under the breastbone or on one side Sharp or stabbing Burning, aching, or a dull[] Signs of pulmonary hypertension, such as palpable impulse over the second left intercostal space, loud P 2, right ventricular S 3 gallop, and a systolic murmur louder on inspiration[] Symptoms Return to top Chest pain Under the breastbone or on one side Especially sharp or stabbing; also may be a burning, aching, or dull, heavy sensation May get worse with[]

  • Heart Failure

    Electrocardiography demonstrated poor R-wave progression in leads V1-V3 with right axis deviation and low voltage criteria.[] People with stable angina may notice pain or discomfort in the chest such as a tight, dull or heavy pain that passes within a few minutes.[] The characteristic apical systolic murmur may be absent in patients with severe MR, due to the abrupt and severe elevation of left atrial pressure.[]

  • Myocardial Infarction

    Biphasic/inverted T waves in V1-5. Poor R wave progression (R wave height 3mm in V3). Abnormal Q waves and T-wave inversion in I and aVL.[] Pain typically is dull or heavy rather than sharp or stabbing, and often is associated with difficult breathing, nausea, vomiting, and profuse sweating.[] Signs Signs of impaired myocardial function 3 rd / 4 th heart sounds Pan systolic murmur Pericardial rub Pulmonary oedema – crepitations in the lungs Hypotension Quiet first[]

  • Acute Myocardial Infarction

    Biphasic/inverted T waves in V1-5. Poor R wave progression (R wave height 3mm in V3). Abnormal Q waves and T-wave inversion in I and aVL.[] Diagnosis is made by detection of a new systolic murmur, and by the documentation of giant "V-waves" on the pulmonary capillary wedge tracing.[] Third and fourth heart sound, systolic murmur if mitral regurgitation or ventricular septal defect develops, pericardial rub.[]

  • Lateral Wall Myocardial Infarction

    EKG Examples Shown below is an EKG demonstrating sinus rhythm and a QRS with a rightward axis, as well as wide Q waves in leads I and aVL as well as a poor R wave progression[] A 55-year-old white woman presented to the emergency department with symptoms of dull aching shoulder and chest pain.[] The patient is usually hypotensive, in acute pulmonary oedema with a new systolic murmur present.[]

  • Congenital Pericardium Anomaly

    Her electrocardiogram showed poor R wave progression. Postero-anterior chest -X ray showed cardiac levoposition with borderline cardiac size (Figure1).[] […] or heaviness in the chest, difficulty in breathing or cough. [7] A 5-year-old male child presented with history of dull aching chest pain for the last 3 months.[] In other cases the ECG may show typical findings such as right axis deviation, incomplete or complete right bundle branch block and poor Rwave progression due to clockwise[]

  • Paradoxical Embolism

    The electrocardiogram showed sinus rhythm (heart rate 61 bpm), first-degree atrioventricular block, right atrial abnormality, poor R-wave progression in the anterior wall[] This patient is a 61 year old female with a history of hypertension and diabetes who presents with 3 weeks of intermittent exertional left sided chest pain.[] Cardiac auscultation revealed a systolic murmur at the left lower sternal border and a splitting of the second heart sound in the pulmonary area.[]

  • Alcoholic Cardiomyopathy

    In the ECG record we stated: sinistogram, regular sinus rhythm with a rate of 90 beats/min, poor R wave progression with 2 mm J-point elevation in V1-V3, 1 mm ST segment depression[] […] discomfort continually, shortness of breath and dull chest pain mainly located in the bilateral hypochondriac regions and together with poor appetite, upper abdominal distending[] Third and fourth heart sounds can be heard, and they signify systolic and diastolic dysfunction.[]

  • Fungal Myocarditis

    wave and pathological Q wave specific to myocardial infarction, not found in myocarditis Pericardial effusion : low voltage (low R-wave with poor progression) Imaging Chest[] When inflammation of the pericardium occurs along with myocarditis, people may have chest pain. Dull or sharp pain may spread to the neck, back, or shoulders.[] Both systolic and diastolic dysfunction can occur [ 156 ].[]

  • Familial Hypertrophic Cardiomyopathy 16

    A chest X-ray showed cardiomegaly (cardiothoracic ratio; 0.55) without pulmonary congestion, and an electrocardiogram showed regular sinus rhythm, poor R wave progression[] For over six years, I have been having attacks with dull but high level pain in my left arm, tightness of the chest, and, often, shortness of breath.[] On auscultation, a grade III/VI systolic murmur at the 4 th left intercostal space was detected. Her blood pressure was 122/66 mmHg.[]