ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT VENTRICULAR MYOCARDIAL INFARCTION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 47
Abstract
BACKGROUND Inferior wall myocardial infarction is complicated by right ventricular infarction in as much as 50% of cases. In patients with RVMI, risk of major complications1 and death in the hospital are greater. Establishing the presence of RVMI in living patients is difficult because of right ventricular dysfunction and frequently it is transient in nature. Echocardiography3 provides a readily accessible tool for the evaluation of right ventricular function. Aims and Objectives-To compare various echo methodologies in assessing right ventricular function in the setting of inferior wall myocardial infarction and its prognostic significance in assessing risk of mortality in various sub groups. Setting and Design- This study was performed in the Department of Cardiology, Chengalpattu Medical College Hospital. 324 consecutive patients admitted with IWMI during the period of March 2016 – February 2018, were included in the study. The study is a prospective observational study. MATERIALS AND METHODS Group 1 – Patients with IWMI with RVMI on ECG (n = 151) Group 2 – Patients with IWMI without RVMI on ECG (n = 173) Transthoracic echocardiography was performed in all patients within 48 hours of symptom onset, within 24 hours whenever feasible. Comparison of measurements between Group 1 and group 2 was performed using a two tailed Student’s t-test. RESULTS RV end-diastolic diameter was increased in patients with RVMI. Tricuspid regurgitation was noted in half of the patients with right ventricular involvement. It was mild in majority of cases. The TAPSE was statistically significantly decreased in patients with right ventricular myocardial infarction. MPI is raised to nearly two-fold the reference values in patients with RVMI. CONCLUSION Right ventricular dimension & contractility were insignificant in detecting RVMI. Right ventricular systolic velocity in patients with RVMI was less compared to patients without RVMI. Increased MPI values were associated with higher mortality. RV dysfunction was worse in those whose echo was done within 24 hrs.
Authors and Affiliations
Raghothaman Sethumadhavan, Sureshkumar Ponnusamy
Keywords
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- EP ID EP548108
- DOI 10.14260/jemds/2018/1126
- Views 71
- Downloads 0
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