Pulmonary embolism in the differential diagnosis of right ventricular myocardial infarction

2019 ◽  
Vol 37 (8) ◽  
pp. 1591-1592
Author(s):  
Oscar M.P. Jolobe
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Differential Diagnosis ◽  
Right Ventricular ◽  
Right Ventricular Myocardial Infarction

scholarly journals Cardiac strain in right ventricular myocardial infarction and pulmonary embolism

2020 ◽  
Vol 25 (2) ◽  
pp. 25-30
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
R. M. Rabinovich ◽  
K. S. Myasnikov ◽  
Yu. A. Orlov
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Differential Diagnosis ◽  
Interventricular Septum ◽  
Apical Segment ◽  
Basal Segment ◽  
Right Ventricular Myocardial Infarction ◽  
Cardiac Strain ◽  
Group 3 ◽  
Group 1

 Aim. To study the prospects of using parameters of right ventricle (RV) longitudinal strain (LS) during systole for the differential diagnosis of RV myocardial infarction (RVMI) and pulmonary embolism (PE).Material and methods. The study included 83 patients who were hospitalized with RVMI or PE in the period from December 2017 to May 2019. The study of RV LS using the two-dimensional speckle-tracking echocardiography was carried out in 30 patients with RVMI (group 1), 15 patients with high-risk PE (group 2), and 38 patients with intermediate-risk PE (group 3).Results. The mean values of RV global LS in patients of groups 1 and 2 did not differ (12,8±2,69 and 12,0±2,56%, respectively) and were significantly lower than in patients of group 3 (15,9±3,03%). The ratio of the interventricular septum (IVS) LS to the RV free wall (FW) LS in the group 1 (1,04±0,43) was significantly lower than in the groups 2 (1,61±0,52) and 3 (1,29±0,38). The ratio of the LS of the RVFW basal segment to the apical segment in group 1 (0,60±0,37) was also significantly lower than in groups 2 (1,69±1,57) and 3 (1,67±1,33).Conclusion. In patients with RVMI, there is a comparable decrease in the LS of the RVFW and IVS, and the LS of the basal segment decreases to a greater extent than the apical one. In patients with PE, the decrease in the LS of the RVFW is more pronounced than in IVS, and the LS of the apical segment decreases to a greater extent than the basal one. These differences can be used for the differential diagnosis of RVMI and PE.

scholarly journals On the 95th anniversary of the first description of right ventricular myocardial infarction

2021 ◽  
Vol 93 (3) ◽  
pp. 348-351
Author(s):  
Aleksandr G. Chuchalin ◽  
Eugeny V. Bobkov
Keyword(s):  
Myocardial Infarction ◽  
Differential Diagnosis ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Left Coronary Artery ◽  
Russian Science ◽  
Artery Thrombosis ◽  
Coronary Artery Thrombosis ◽  
Right Ventricular Myocardial Infarction ◽  
Therapeutic Schools

An analysis of the publication of the outstanding Russian therapist and cardiologist D.D. Pletnev (18711941) is given in the article. In 1925, he published an article On the issue of lifetime differential diagnosis of right and left coronary artery thrombosis in the journal Russian Clinics in Russian and German languages. Timely diagnosis of right myocardial infarction determines the prognosis and treatment tactics of this disease, and the case itself has a priority for the Russian science. The authors emphasize the outstanding talent of D.D. Pletnev as a physician and scientist, whose name is associated with the emergence of one of the most brilliant therapeutic schools (A.L. Myasnikov, E.I. Chazov, etc.).

scholarly journals Right Ventricular Longitudinal Strain in Acute Pulmonary Embolism and Right Ventricular Myocardial Infarction in Patients with McConnell’s Sign

Kardiologiia ◽  
2020 ◽  
Vol 60 (7) ◽  
pp. 20-27
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
R. M. Rabinovich ◽  
K. S. Myasnikov
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Interventricular Septum ◽  
Cutoff Point ◽  
Apical Segment ◽  
Chamber View ◽  
Right Ventricular Myocardial Infarction ◽  
The Right

Aim      To study the right ventricular (RV) myocardial longitudinal systolic strain in patient with RV myocardial infarction (MI), and pulmonary embolism (PE) with and without McConnell’ phenomenon.Material and methods  This study included 53 patients with PE (mean age, 59.0±15.1 years; men, 58.5 %) and 30 patients with RVMI (mean age, 61.8±10.9 years; men, 90 %). Longitudinal strain of basal, medial and apical segments of the RV free wall (RVFW) and the interventricular septum (IVS) was determined in the mode of two-dimensional speckle tracking. Ratio of the IVS apical strain to the RVFW strain (apical ratio) was calculated. Systolic excursion of the RVFW apical segment (apical excursion) was measured in the anatomical M-mode from the apical four-chamber view.Results The McConnell’s sign was observed in 23 (43.4 %) of 53 patients with PE and in 16 (53.3 %) of 30 patients with RVMI (p>0.05). Irrespective of the cause for the RV damage, patients with the McConnell’s sign had higher values of the apical ratio (1.69±0.50 vs. 0.95±0.22; p<0.001; cutoff point, 1.18) and apical excursion (7.9±1.7 vs. 2.6±1.4 mm; p<0.001; cutoff point, 5.0 mm). Apical excursion closely correlated with the value of apical ratio (r=0.65; p<0.001) but not with the RVFW apical segment strain (r= –0.07; p>0.05).Conclusion      Incidence of the McConnell’s sign was similar in patients with PE and RVMI. McConnell’s sign is based on a passive systolic shift of the RVFW apical segment, which develops during contraction of the IVS apical segment. The greater the ratio of IVS apical segment to RBFW global strain the greater the amplitude of this shift. With the ratio value of 1.18 or more, the systolic shift of RVFW apical segment was >5 mm, which was visually perceived as the McConnell’s sign. 

scholarly journals Isolated right ventricular myocardial infarction: a case report

2020 ◽  
Author(s):  
Adeogo Akinwale Olusan ◽  
Paul Francis Brennan ◽  
Paul Weir Johnston
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Circumflex Artery ◽  
Right Ventricular Myocardial Infarction ◽  
Percutaneous Coronary

Abstract Background Isolated right ventricular myocardial infarction (RVMI) due to a recessive right coronary artery (RCA) occlusion is a rare presentation. It is typically caused by right ventricle (RV) branch occlusion complicating percutaneous coronary intervention. We report a case of an isolated RVMI due to flush RCA occlusion presenting via our primary percutaneous coronary intervention ST-elevation myocardial infarction pathway. Case summary A 61-year-old female smoker with a history of hypercholesterolaemia presented via the primary percutaneous coronary intervention pathway with sudden onset of shortness of breath, dizziness, and chest pain while walking. Transradial coronary angiography revealed a normal left main coronary artery, large left anterior descending artery that wrapped around the apex and dominant left circumflex artery with the non-obstructive disease. The RCA was not selectively entered despite multiple attempts. The left ventriculogram showed normal left ventricle (LV) systolic function. She was in cardiogenic shock with a persistent ectopic atrial rhythm with retrograde p-waves and stabilized with intravenous dobutamine thus avoiding the need for a transcutaneous venous pacing system. A computed tomography pulmonary angiogram demonstrated no evidence of pulmonary embolism while an urgent cardiac gated computed tomography revealed a recessive RCA with ostial occlusive lesion. A cardiac magnetic resonance imaging confirmed RV free wall infarction. She was managed conservatively and discharged to her local district general hospital after 5th day of hospitalization at the tertiary centre. Discussion This case describes a relatively rare myocardial infarction presentation that can present with many disease mimics which can require as in this case, a multi-modality imaging approach to establish the diagnosis.

Remote right ventricular myocardial infarction mimicking chronic pericardial constriction

1982 ◽  
Vol 103 (5) ◽  
pp. 912-914 ◽  
Author(s):  
Samuel Butman ◽  
Harold G Olson ◽  
Wilbert S Aronow ◽  
Kenneth P Lyons
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Right Ventricular Myocardial Infarction
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