Right ventricular myocardial infarction and its consequences
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 12
Abstract
Right ventricular (RV) myocardial infarction (MI) occurs in 30-50% of patients with inferior myocardial infarction (MI) caused mainly by right coronary artery lesion. RV MI diagnosis remains a challenge due to RV complex morphology and wide spectrum of possible hemodynamic disturbances in relation to size of myocardial injury. Patients may clinically present with hypotension, dilatation of jugular venous, all in the presence of clear lung fields. The ST – segment elevation of ≥ 0.1 mV in the lead V4R is the most recommended electrocardiographic sign used for diagnosis of MI RV. Echocardiography is a useful tool in RV MI diagnosis. Abnormal findings include RV dilatation and parameters of right atrial pressure elevation, RV diastolic and systolic dysfunction. The proper management requires early diagnosis and as early as possible reperfusion by primary percutaneous coronary intervention or if unavailable by fibrinolytic therapy. The treatment also includes maintenance of adequate right ventricular preload and atrioventricular synchrony. MI RV, indepedently of LV injury, leads to increase in early mortality and morbidity (cardiogenic shock, life threatening rhythm disturbances, high grade atrioventricular blocks, mechanical complications of MI). Recovery of RV function occurs in the majority of patients treated by successful reperfusion. RV dysfunction provides valuable information of worsening the prognosis in terms of mortality and heart failure in long-term follow-up.
Authors and Affiliations
Krzysztof Smarż, Beata Zaborska
Keywords
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