Case 15 Question 2

What is the differential diagnosis of this ECG finding?

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The differential diagnosis of poor R wave progression includes:

1. Old anteroseptal infarct (Q waves in V1 through V3)

2. Left ventricular hypertrophy

3. Left anterior fascicular block

4. Left bundle branch block

5. Late transition or clockwise rotation of the heart (normal variant)

6. Wolff-Parkinson-White