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Poor R-wave progression (PRWP) is defined as an R-wave < 3 mm by lead V3.
Consider the 8 L's of PRWP:
LAD lesion (prior anteroseptal MI)
Left bundle branch block
Left ventricular hypertrophy
Left anterior fascicular block
Low voltage
Long life (elderly)
Lungs (COPD)
Lead misplacement
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