scholarly journals ECHOCARDIOGRAPHY IN RIGHT VENTRICULAR MYOCARDIAL INFARCTION

2013 ◽  
Vol 12 (3) ◽  
pp. 58-62
Author(s):  
H. G. Hayrapetyan ◽  
K. G. Adamyan
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Structure And Function ◽  
Two Dimensional ◽  
Tei Index ◽  
Global Function ◽  
Area Change ◽  
2D Echocardiography ◽  
Right Ventricular Myocardial Infarction ◽  
And Function

This paper presents the views on two-dimensional (2D) echocardiography (EchoCG) in the assessment of right ventricular (RV) structure and function. In order to quantitatively assess the RV global function, the following parameters can be used: RV outflow tract shortening fraction, RV fractional area change, tricuspid annular plane systolic excursion, and Tei index. For these parameters, their assessment methods, as well as their strengths and limitations, are discussed.

scholarly journals Echocardiographic Assessment of Right Ventricular Function in Post Thrombolysed Acute Inferior Wall Infarction Patients with Angiographic Correlation

2021 ◽  
Vol 10 (31) ◽  
pp. 2406-2411
Author(s):  
Sabapathy Kannappan
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Performance Index ◽  
Inferior Wall ◽  
Myocardial Performance ◽  
Area Change ◽  
Right Ventricular Myocardial Infarction ◽  
Infarct Related Artery ◽  
Echocardiographic Examination ◽  
Rv Function

BACKGROUND A significant number of patients with acute Inferior wall infarction will have RV dysfunction and most of them have occlusion of either right or left circumflex coronary artery. But RV assessment is not done routinely in echocardiographic examination. Patients present with inferior wall myocardial infarction (IWMI) subsequently develop right ventricular myocardial infarction (RVMI) and have poor prognosis. In this study we wanted to evaluate the incidence of RVMI and the role of echocardiography in assessing RV function and its impact in predicting infarct related artery by angiographic analysis in acute IWMI after thrombolysis. METHODS 86 patients with acute IWMI after thrombolysis were randomly selected. Echocardiographic examination of RV function was performed within 72 hours after thrombolysis. We applied RV echo parameters like FAC (Fractional Area Change %), TAPSE (Tricuspid Annular Plane Systolic Excursion), RV S’ (RV Systolic Excursion Velocity) and MPI (Myocardial Performance Index) to assess RV function. 48 patients underwent coronary angiogram which included 10 patients with normal RV function, rest with RV dysfunction. RESULTS Among 86 patients, we compared 64 patients of RV dysfunction with 22 patients having normal function. Echo indices were significantly lower in RV dysfunction group. FAC ( 27 ± 5.95 vs 45 ± 5.4 ) TAPSE (8.5 ± 2.0 19.59 ± 2.8 ), RV S’ ( 5.78 ± 1.26 vs 17.2 ± 3.5 ) and RVMPI (0.22 ± 0.03 vs 0.57± 0.03). Angiographic analysis of 28 of 38 patients with RV dysfunction showed significant proximal lesion in RCA as compared to only 2 among 10 patients with normal RV function. CONCLUSIONS Conventional echo examination will underestimate RV dysfunction hence we applied echo parameters like FAC, TAPSE, RV S’ and RVMPI and a significant proportion of thrombolysed acute IWMI patients were found to have RV dysfunction and it was also helpful in the prediction of infarct related artery which would be predominantly a critical proximal RCA occlusion. KEY WORDS RVMI (Right Ventricular Myocardial Infarction), FAC (Fractional Area Change %), TAPSE (Tricuspid Annular Plane Systolic Excursion), RV S’ (RV Systolic Excursion Velocity) ,MPI (Myocardial Performance Index), IRA ( Infarct Related Artery)

scholarly journals Two-dimensional echocardiography compared to cardiac computed tomography for assessment of left ventricular volume and function in patients with anteroapical aneurysm

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
O Nemchyna ◽  
N Solowjowa ◽  
M Dandel ◽  
Y Hrytsyna ◽  
J Knierim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cox Regression ◽  
Left Ventricular ◽  
Two Dimensional ◽  
Prognostic Role ◽  
2D Echocardiography ◽  
Significant Difference ◽  
Lv Volumes ◽  
And Function ◽  
Lv Aneurysm

Abstract Funding Acknowledgements Type of funding sources: None. Background. Two-dimensional (2D) echocardiography is widely accepted method for the assessment of left ventricular (LV) morphology and function after myocardial infarction and for initial preoperative evaluation of patients planned for surgical ventricular repair (SVR). Magnetic resonance imaging and cardiac computer tomography (CT) provide more accurate measurements, but not always available. Purpose. The aim of this study was to compare 2D-echocardiography and CT for preoperative assessment of patients with LV aneurysm in order to optimize the perioperative management in SVR. Methods. Patients (n = 179, mean age 62.6 ± 11 years, 23.5% women) with LV anteroapical aneurysm due to myocardial infarction were examined by echocardiography and CT before SVR. LV end-diastolic and end-systolic volumes (LVEDV and LVESV) and ejection fraction (EF) obtained by two methods were compared pairwise. Prognostic role for the prediction of all-cause death was assessed for preoperative parameters in multivariate Cox regression model adjusted for patient age, sex, NYHA class, diabetes mellitus, renal failure, atrial fibrillation and arterial hypertension. Results. There was a strong correlation for preoperative LVEDV and LVESV measured by echocardiography and CT (r = 0.85, r = 0.87, p < 0.0001), however volumes obtained by echocardiography were smaller compared to those by CT (Table) with higher difference in patients with more dilated LV, as demonstrated by Bland-Altman analysis (Fig.). No significant difference in mean preoperative EF was observed with moderate correlation between two methods (r = 0.67, p < 0.0001). In total 68 patients died during median follow up of 5.3 years (IQR: 1.7-8.7 years) after SVR. Comparable predictive value was demonstrated for LVEDV measured by CT and echocardiography (for 10 ml increase HR = 1.04, p = 0.004 and HR = 1.06, p = 0.0001), as well as for LVESV (for 10 ml increase HR = 1.04, p = 0.001 and HR = 1.07, p = 0.0001) and for EF (for 5% increase HR = 0.83, p = 0.004 and HR = 0.81, p = 0.004). Conclusion. In patients with LV aneurysm 2D-echocardiography may be used for the assessment of LV volumes and function and have similar prognostic role compared to CT in patients evaluated for SVR. Underestimation of LV volumes by echocardiography must be considered, especially in patients with more dilated LV. Comparison of CT and echocardiography Parameter CT Echo Mean difference p-value LVEDV, ml LVESV, ml EF, % 289 ± 104 198 ± 97 34 ± 12 222 ± 81 149 ± 67 35 ± 9 67 ± 56 49 ± 51 -0.9 ± 9.2 <0.0001 <0.0001 0.215 Abstract Figure. Bland-Altman plots for LVEDV and LVESV

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.

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