scholarly journals Clinical profiling of right ventricular infarction in patients with acute inferior wall myocardial infarction

2019 ◽  
Vol 6 (1) ◽  
pp. 35
Author(s):  
Vinod Khandait ◽  
Suresh Sarwale ◽  
Chandrashekhar Atkar ◽  
Harshwardhan Khandait
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Prospective Observational Study ◽  
Early Recognition ◽  
Inferior Wall ◽  
Coronary Risk Factors ◽  
Right Ventricular Infarction ◽  
Right Ventricular Myocardial Infarction ◽  
The Difference ◽  
Ventricular Infarction

Background: Incidence of Right Ventricular Myocardial Infarction (RVMI) associated with Inferior Wall Myocardial Infarction (IWMI) is reported to be quite high (30%-50%). To diagnose coexisting RVMI is important, since its early recognition and proper treatment reduces overall morbidity and mortality in IWMI. Author assessed the incidence and clinically profiled patients with right ventricular infarction in acute inferior wall myocardial infarction and analysed the effects of RVMI on clinical outcome of IWMI.Methods: A total of 150 patients of IWMI were evaluated in the present hospital based prospective observational study over duration of two years. They were evaluated for coronary risk factors like diabetes mellitus, hypertension, smoking, obesity, alcohol and dyslipidemia. Twelve-lead ECG, cardiac enzyme assay and echocardiography were undertaken in all the participants.Results: Of the total 150 patients, 45 (30%) patients had right ventricular myocardial infarction (RVMI). Complications were significantly lower in patients with isolated IWMI as compared to patients with IWMI and associated RVMI except pulmonary edema (p<0.05). Of the total 22 (14.67%) deaths in the present study, 18 (12%) had associated RVMI and 4 (2.66%) isolated IWMI, the difference being statistically significant.Conclusions: Involvement of right ventricle increases rate of complications as well as the mortality rate in patients with inferior wall myocardial infarction.

scholarly journals Right Ventricular Myocardial Infarction : Presentation and Acute Outcomes

2018 ◽  
Vol 25 ◽  
pp. 42-46
Author(s):  
MN Huda ◽  
MZ Sayeed ◽  
MK Rahman ◽  
MMR Khan ◽  
ARMS Ekram
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Tertiary Care ◽  
Inferior Wall ◽  
Inferior Myocardial Infarction ◽  
Cross Sectional ◽  
Right Ventricular Infarction ◽  
Right Ventricular Myocardial Infarction ◽  
Number Of Patients ◽  
Ventricular Infarction

Right Ventricular Infarction (RVI) complicating inferior wall myocardial infarction (MI) is common and associated with significant morbidity and mortality. We try to systematically assess the incidence, clinical presentation and in hospital outcomes of right ventricular myocardial infarction in a tertiary-care set up. This study was a descriptive, cross sectional observational series of consecutive patients with RVMI. All patients with acute inferior myocardial infarction (n=100) were enlisted. RVMI was diagnosed by ≥1mm ST elevation in lead V4R in right sided electrocardiogram. RVI occurred in 31% (n=31) of patients of acute inferior infarctions. Patients with isolated inferior myocardial infarction served as controls (n=69). Echocardiography was performed within 24 hours of admission. From both groups, 51% were qualified for thrombolysis. The incidence of hypotension (96.7%), cardiogenic shock (64.5%), bradycardia and heart block were much higher in RVI than in inferior myocardial infarction. Clinically manifest RV dysfunction (raised jugular venous pulse, hypotension and tricuspid regurgitation) and right ventricular dilatation detected by echocardiography was seen in a variable number of patients. In hospital mortality rate was significantly higher (n=13, 41.9%) in right ventricular infarction group than in inferior myocardial infarction group (n=2, 2.9%)TAJ 2012; 25: 42-46

scholarly journals An analysis of incidence and complications of right ventricular infarction in patients with inferior wall myocardial infarction

2018 ◽  
Vol 70 ◽  
pp. S40-S41
Author(s):  
Waseem Rafeek Ahmed Nadaf, Shashikantha ◽  
Padmanabh Kamath ◽  
Narayana M. Bhat ◽  
Narasimha Pai ◽  
Rajesh Bhat ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Inferior Wall ◽  
Right Ventricular Infarction ◽  
Ventricular Infarction

scholarly journals STUDY OF RIGHT VENTRICULAR INFARCTION IN INFERIOR WALL MYOCARDIAL INFARCTION AT MEDICINE DEPARTMENT OF GMC, BETTIAH BIHAR

2020 ◽  
pp. 1-2
Author(s):  
Mahendra Kumar ◽  
Dharmendra Prasad ◽  
Parshuram Yugal ◽  
Debarshi Jana
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Medicine Department ◽  
Right Ventricular Infarction ◽  
St Elevation ◽  
Ventricular Infarction ◽  
Electrocardiogram Ecg

Background: Right ventricular infarction (RVI) is frequently associated with inferior wall myocardial infarction (MI). Methods: This study was designed to identify the burden of RVI in patientspresenting with inferior wall MI (n=50) byright precordial electrocardiogram (ECG) and comparing it with echocardiography (ECHO). Results: Their mean age was (54.5 ± 11.9 years); there were 42 males. ST elevation of greater than 1 mm in rightprecordial leads (RPL) suggestive of RVI was evident in 16 (32%) cases. Among the RPL (V3R - V6R) V4R and V5Rshowed sensitivity of 87.5%. The 12-lead ECG finding of ST-elevation greater than 1 mm in lead III and lead III/IIgreater than 1, had poor sensitivity (75%), specificity (88.2%) compared to ST- elevation of greater than 1 mm in any ofthe RPL (100%). Both the echocardiography criteria, namely right ventricular end-diastolic dimension (RVEDD) greaterthan 25 mm (92.3%) and the ratio of RVEDD to left ventricular end-diastolic dimension (RVEDD/LVEDD) greaterthan 0.7 (90%) indicating right ventricle (RV) dilatation was observed significantly more frequently in RVI group. Conclusions: RVI occurs in more than one-third of patients with acute inferior wall MI. All the patients with inferior wallMI should have RPL recorded as early as possible for evidence of RVI, of which V4R, V5R have the highest sensitivity.

scholarly journals Acute provoked pulmonary embolism masquerading as inferior wall myocardial infarction with right ventricular infarction

2021 ◽  
Vol 10 (2) ◽  
pp. 68
Author(s):  
Debasish Das ◽  
Tutan Das ◽  
Debasis Acharya ◽  
Shashikant Singh ◽  
JaideepDas Gupta ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Inferior Wall ◽  
Right Ventricular Infarction ◽  
Ventricular Infarction

P264 Comparison of in-hospital mortality between acute inferior wall STEMI patients with right ventricular infarction and without right ventricular infarction undergoing a primary PCI in KCMH

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
S Preechawuttidej ◽  
S Srimahachota
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Right Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Hospital Death ◽  
Inferior Wall ◽  
Right Ventricular Infarction ◽  
St Elevation ◽  
Ventricular Infarction

Abstract Background Patients with acute inferior wall ST elevation myocardial infarction, if there is a right ventricular myocardial infarction involvement, they have pretended a worse prognosis with hemodynamic and electrophysiologic complications causing higher in-hospital morbidity and mortality. However most patients in previous studies were mainly treated with intravenous fibrinolysis and also studied in the Caucasian populations. Objectives To compare the in-hospital mortality rate of patients with acute inferior wall ST elevation myocardial infarction with and without right ventricular infarction involvement, whom were treated with primary percutaneous coronary intervention (PPCI). Methods The study was a retrospective descriptive study which enrolled patients with acute inferior wall ST elevation myocardial infarction who were treated with PPCI in our hospital from 1 January 2007 - 31 December 2016. Results Among 452 acute inferior wall ST elevation myocardial infarction patients who were treated with PPCI, there were 99 patients who had right ventricular infarction involvement, the in-hospital mortality rate was 23.2%, mainly due to cardiogenic shock, compared with 5.1 % in patients who had no right ventricular infarction (p &lt; 0.001). Patients with right ventricular infarction had a significantly higher incidence of cardiogenic shock (48.5% versus 15.6%, P &lt; 0.001), the lower number of left ventricle ejection fraction (51.15 ± 17.27% versus 55.79 ± 12.46%, p = 0.037), the higher incidence of complete heart block (33.3% versus 11.9%, p &lt; 0.001) and ventricular tachycardia (15.2% versus 5.9%, p = 0.003). After adjustment for age, female sex, diabetes, hypertension, previous myocardial infarction, cardiogenic shock on admission, left ventricular ejection fraction, ventricular tachycardia and complete heart block, the right ventricular infarction remained the independent predictor of in-hospital death (adjusted hazard ratio, 1.69; 95% confidence interval, 0.38 to 7.48; P = 0.489) and significant independent predictor for 1-year mortality (adjusted hazard ratio, 2.76; 95% confidence interval, 1.08 to 7.03; P = 0.034). Conclusion Patients with acute inferior wall STEMI whom were treated with PPCI, if there was right ventricular infarction involvement, the in-hospital death and 1-year mortality were significantly higher than who were without right ventricular 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.

Sign in / Sign up

Export Citation Format

Share Document