scholarly journals Adverse events from nitrate administration during right ventricular myocardial infarction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Matt Wilkinson-Stokes ◽  
Marc Colbeck ◽  
Scott Stewart
Keyword(s):  
Myocardial Infarction ◽  
Adverse Events ◽  
Right Ventricular ◽  
Right Ventricular Myocardial Infarction

scholarly journals Right ventricular myocardial infarction and adverse events from nitrates: A narrative review

2021 ◽  
Vol 18 ◽  
Author(s):  
Matt Wilkinson-Stokes
Keyword(s):  
Myocardial Infarction ◽  
Cohort Study ◽  
Adverse Events ◽  
Right Ventricular ◽  
Statistical Power ◽  
Best Practice ◽  
Web Of Science ◽  
Narrative Structure ◽  
Right Ventricular Myocardial Infarction ◽  
History Of

Introduction There is ubiquitous belief that right ventricular myocardial infarction (RVMI) patients are pre-load dependent, and that administering nitrates to this cohort may cause adverse events – most notably hypotension. This article charts a narrative history of RVMI and nitrates: from the initial recognition of RVMI and early support of the use of nitrates, through the spread of the view against nitrates, and to the recent publication of evidence once again supporting their use. Methods Four databases were systematically searched (PubMed, Embase, Medline, Web of Science) and results screened by title, then abstract, and finally full text. Results were presented using a chronological narrative structure. Results The view against the use of nitrates during RVMI can be traced back to a single 1989 cohort study of 28 patients, then later being adopted by a series of influential secondary evidence papers, and ultimately by international guidelines. In 2016, 2017 and 2019, new cohort studies totalling 1046 patients were presented, all of which concluded that nitrates are safe to administer during RVMI. Conclusion This article charts how a single retrospective cohort study with low statistical power came to form the dominant narrative on best practice despite complex and conflicting primary evidence.

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

scholarly journals Early Implementation of Veno-Venous Hemofiltration and Use of Rotational Atherectomy in a Patient with ST-Elevation Myocardial Infarction Complicated by Cardiogenic Shock- case report.

2020 ◽  
Author(s):  
Monika Durak ◽  
Marek Tomala ◽  
Bartłomiej Nawrotek ◽  
Andrzej Machnik ◽  
Jacek Legutko
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Cardiogenic Shock ◽  
Right Ventricular ◽  
Kidney Injury ◽  
Novel Treatment ◽  
Early Implementation ◽  
Right Ventricular Myocardial Infarction ◽  
St Elevation

We report a patient with cardiogenic shock (CS) in the course of acute right ventricular myocardial infarction (MI). Our case highlights the use of continuous veno-venous hemofiltration as a novel treatment option for acute kidney injury in the setting of CS and the use of rotational_atherectomy in patients with MI.

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