Causes and diagnosis of tall R waves in V1

Diagnosis	Confirmatory clues
True posterior infarct	ST ↓, T ↑ in V1-V2; Q waves and ST ↑ V7-V9
Right ventricular hypertrophy	RAD; RAE; secondary ST-Ts; V7-V9 normal
Ventricular septal hypertrophy	Associated Q waves; LVH; V7-V9 normal or deep narrow Q waves
Right bundle branch block	Wide QRS; broad S in V1, V6; R peaks late in V1; V7-V9 normal or broad S waves
Wolff-Parkinson-White syndrome	Short PR; delta wave; V7-V9 normal or delta wave
Normal variant	No other abnormalities

Tall_R_waves_V1.htm

LVH: left ventricular hypertrophy; RAD: right-axis deviation; RAE: right atrial enlargement.

Graphic 72039 Version 2.0

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