Create issue ticket

21 Possible Causes for Poor R Wave Progression, Pulmonary Systolic Murmur, S4 Gallop

  • Right Ventricular Outflow Obstruction

    Examination revealed an ejection systolic murmur in the pulmonary area. The electrocardiogram showed complete heart block.[onlinejacc.org] On examination there was a systolic thrill and a loud ejection murmur in the pulmonary area.[heart.bmj.com] Statistics from Altmetric.com A 27 year old banker was referred by his general practitioner with constitutional symptoms and a murmur.[heart.bmj.com]

  • Pulmonary Embolism

    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[emedicine.medscape.com] murmur over the left sternal border that is louder during inspiration, hepatomegaly, ascites, and dependent pitting edema.[emedicine.medscape.com] Patients may have elevated jugular venous pressure, right ventricular heave, palpable impulse in the left second intercostal space, right ventricular S 3 gallop, systolic[emedicine.medscape.com]

  • Cor Pulmonale

    R wave progression RAE with and RVH multifocal atrial tachycardia return to top Differential Diagnosis return to top Treatments Consequences and Course return to top The[sharinginhealth.ca] The S3 and S4 sounds resemble a horse gallop. The presence of the fourth heart sound is found in cor pulmonale.[medical-dictionary.thefreedictionary.com] Split second heart sound with loud pulmonary component. Systolic ejection murmur with a sharp ejection click over the pulmonary artery (advanced sign).[patient.info]

  • 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.[lifeinthefastlane.com] Heart sounds are auscultated for S3 or S4 gallops or new heart murmurs. Patient care and other activities should be organized to allow for periods on uninterrupted rest.[medical-dictionary.thefreedictionary.com] 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[almostadoctor.co.uk]

  • Anterior Myocardial Infarction

    The remarkable feature is the poor R wave progression in the V1 and V2 leads and the ST elevation and T wave changes in leads V1 to V4 and I and aVL.[wikidoc.org] An S4 gallop sound may be heard when listening to the heart with the stethoscope (the S4 sound occurs just at the end of the relaxation or diastole phase of the ventricles[calshipleymd.com] Diagnosis is made by detection of a new systolic murmur, and by the documentation of giant "V-waves" on the pulmonary capillary wedge tracing.[brown.edu]

  • 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.[lifeinthefastlane.com] Diagnosis is made by detection of a new systolic murmur, and by the documentation of giant "V-waves" on the pulmonary capillary wedge tracing.[brown.edu] Third and fourth heart sound, systolic murmur if mitral regurgitation or ventricular septal defect develops, pericardial rub.[patient.info]

  • Restrictive Cardiomyopathy

    Figure 3 shows atrial fibrillation, poor R wave progression, and diffuse ST-segment abnormalities in an ECG from a patient with ischemic cardiomyopathy.[clevelandclinicmeded.com] Presentation Usually presents with heart failure but normal systolic function: dyspnoea, fatigue, loud third heart sound, pulmonary oedema, murmurs due to valve incompetence[patient.info] murmurs of mitral and tricuspid regurgitation may also be auscultated Diagnosis Diagnostic right and left heart catheterization is an important diagnostic modality Pressures[pathologyoutlines.com]

  • Right Ventricular Hypertrophy

    Figure 3 shows atrial fibrillation, poor R wave progression, and diffuse ST-segment abnormalities in an ECG from a patient with ischemic cardiomyopathy.[clevelandclinicmeded.com] On auscultation, an accentuated second pulmonary sound (S2), a third heart sound termed a ‘right ventricular gallop’, as well as a systolic murmur over the tricuspid area[en.wikipedia.org] The fact that poor R wave in precardial leads occur in most cases of COPD (whether or not RVH is present or not) convey an important message.[drsvenkatesan.com]

  • 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[wikidoc.org] Signs and symptoms of right-sided heart failure such as elevated jugular venous pressure, Kussmaul’s sign (inspiratory increase in jugular venous pressure), S4 and S3 gallops[cathlabdigest.com] The patient is usually hypotensive, in acute pulmonary oedema with a new systolic murmur present.[bsecho.org]

  • Posterior Myocardial Infarction

    ) LVH (may have QS pattern or poor R wave progression in leads V1-3) RVH (tall R waves in V1 or V2 may mimic true posterior MI) Complete or incomplete LBBB (QS waves or poor[ecg.utah.edu] Signs and symptoms of right-sided heart failure such as elevated jugular venous pressure, Kussmaul’s sign (inspiratory increase in jugular venous pressure), S4 and S3 gallops[cathlabdigest.com] Diagnosis is made by detection of a new systolic murmur, and by the documentation of giant "V-waves" on the pulmonary capillary wedge tracing.[brown.edu]