scholarly journals Acute Isolated Right Ventricular Infarction: Unusual Presentation of Anterior ST-Segment-Elevation Myocardial Infarction

2019 ◽  
Vol 46 (2) ◽  
pp. 151-154
Author(s):  
Wayne W. Zhong ◽  
Matthew Blue ◽  
Andrew D. Michaels
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Right Coronary Artery ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
St Segment ◽  
Right Ventricular Myocardial Infarction ◽  
Ventricular Infarction ◽  
Electrocardiographic Leads

Acute right ventricular infarction presenting with ST-segment elevation in the anterior precordial electrocardiographic leads is an unusual event. Anterior ST-segment elevation typically suggests occlusion of the left anterior descending coronary artery. It should be recognized, however, that occlusion of a right coronary artery branch can cause isolated ST-segment elevation in leads V1 and V2 on a standard 12-lead electrocardiogram. We describe the cases of 2 patients who presented with acute chest syndrome with isolated ST-segment elevation in leads V1 and V2. Emergency coronary angiograms revealed that acute thrombotic occlusion of the right ventricular marginal branch of the dominant right coronary artery caused the clinical manifestations in the first patient, whereas occlusion of the proximal nondominant right coronary artery was the culprit lesion in the second patient. Both lesions caused right ventricular myocardial infarction. The patients underwent successful primary percutaneous coronary intervention. These cases illustrate the importance of carefully reviewing angiographic findings to accurately diagnose an acute isolated right ventricular myocardial infarction, which may mimic the electrocardiographic features of an anterior-wall myocardial infarction.

scholarly journals Diagnostic value of standard electrocardiogram in acute right ventricular myocardial infarction

2019 ◽  
Vol 29 (2) ◽  
Author(s):  
Ali Taherinia ◽  
Koorosh Ahmadi ◽  
Mehran Bahramian ◽  
Peyman Khademhosseini ◽  
Zabihollah Taleshi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Significant Relationship ◽  
Diagnostic Value ◽  
P Value ◽  
Right Ventricular Infarction ◽  
St Segment ◽  
Right Ventricular Myocardial Infarction ◽  
Ventricular Infarction

Myocardial infarction (MI) (i.e., heart attack) is the irreversible death (necrosis) of heart muscle secondary to prolonged lack of oxygen supply (ischemia) which accounts for a large number of deaths in the hospital. Diagnosis of myocardial infarction is confirmed based on clinical manifestations and electrocardiographic changes along with increased cardiac enzymes. Electrocardiogram (ECG) is one of the safest and easiest methods in the first place. Therefore, this study aimed to investigate the diagnostic value of standard electrocardiogram in the diagnosis of acute right ventricular infarction following lower cardiac infarction. This research was carried out at a time interval of one and a half years to diagnose acute primary infarction. In this method, the diagnostic value of ST↓ in lead I, ST↓ in lead aVL and I ST↓ + aVL, compared with ST↑ in lead V4R was investigated for diagnosis of right ventricular infarction. ST↑ in the lead V4R is a gold standard for the detection of right ventricular MI. All the patients who had the inclusion criteria were allowed to participate in the study. A total of 66 patients participated in the study. Accordingly, 58 (87%) were male and 8 (13%) were female. The mean age of the population was 54.9 ± 11.41. According to the ST↑ standard in lead V4R, 26 patients (39%) had right ventricular myocardial infarction. There was no significant relationship between angina pectoris and premature infarction (P-Value = 0.869). In this study, the right ventricular was most commonly involved in right coronary artery (78%). There was no significant relationship between the occlusion of right coronary artery and right ventricular infarction in 60 patients (P-Value = 0.94). The results showed that electrocardiogram manifestations help determine the occlusion site and the area at risk (ST↓ in lead aVL and aVL + I, sensitivity = 96%). In myocardial infarction, symptoms such as the ST-Segment elevation in lead aVR and ST-Segment depression in the lower leads are possible. Accordingly, in the lower infarction, ST changes in the leads V1-V6 are helpful in detecting patients at risk. Thus, the use of electrocardiogram in acute myocardial infarction helps detect more invasive patients and prevents extensive myocardial damage and other complications.

scholarly journals Acute myocardial infarction with ST segment elevation in inferior and anterior leads: right ventricular infarction

2010 ◽  
Vol 2010 (feb02 1) ◽  
pp. bcr0320091700-bcr0320091700
Author(s):  
R. Berent ◽  
J. Auer ◽  
S. von Duvillard ◽  
H. Sinzinger ◽  
D. Steinbrenner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Right Ventricular ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
St Segment ◽  
Ventricular Infarction

scholarly journals Qrs-Complex Fragmentations and Right Ventricular Infarction in the Presence of Inferior Infarction with Triple-Vessels Disease; Bad Initials but a Good Outcome

2022 ◽  
Vol 3 (1) ◽  
pp. 01-04
Author(s):  
Yasser Mohammed Hassanain Elsayed
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Heavy Smoker ◽  
Qrs Complex ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Ventricular Infarction

Rationale: The term “fragmentation of the QRS complex” denotes the existence of high-frequency potentials (spikes) in the QRS-complex. It is either a marker for cardiac structural diseases inducing biventricular hypertrophy or any condition interfering with the normally homogeneous depolarization status inside the myocardium. An associated right ventricular infarction with inferior infarction maybe carry a risk impact and serious complications. Patient concerns: A 64-year-old married, farmer, heavy smoker, Egyptian male patient presented with acute severe chest pain and inferior with right ventricular ST-segment elevation myocardial infarction and fragmentation of the QRS complex. Diagnosis: QRS-complex fragmentations and right ventricular infarction in the presence of inferior infarction with the triple-vessels disease. Interventions: Electrocardiography, oxygenation, streptokinase intravenous infusion, echocardiography, and percutaneous transluminal coronary angioplasty. Outcomes: Dramatic response of acute inferior with right ventricular ST-segment elevation myocardial infarction and QRS-complex fragmentations to streptokinase. Lessons: Despite the presence of inferior and right ventricular ST-segment elevation myocardial infarction with QRS-complex fragmentations, but there is no correlation with the severity of the disease. Dramatic clinical and electrocardiographic response signifying the role of streptokinase and fibrinolytic. The presence of fragmentation of the QRS-complex may have a bidirectional impact from seriousness to complications.

Anomalous interarterial right coronary artery culprit vessel in ST-segment elevation myocardial infarction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ilias Nikolakopoulos ◽  
Bernardo B. C. Lopes ◽  
Evangelia Vemmou ◽  
Judit Karacsonyi ◽  
João Cavalcante ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment
Sign in / Sign up

Export Citation Format

Share Document