Complete Absence of Precordial R Waves Due to Absence of Left-Sided Pericardium


  • Disclosures: The authors have no conflict of interests.

  • Financial support: N/A.

Jean Champagne, M.D., Department of Cardiology, Quebec Heart and Lung Institute, 2725 Chemin Sainte-Foy, Quebec G1V 4G5, Canada. Fax: +1-418-656-4581; E-mail:


Poor R-wave progression (PRWP) in the precordial leads on random ECG is relatively frequent in the general population and includes a broad differential diagnosis. Here, we present for the first time a case of complete absence of precordial R waves associated with a prominent R wave in aVR due to the absence of the left-sided pericardium in a 44-year-old woman who experienced sudden cardiac death.