scholarly journals The results of the treatment of right ventricle myocardial infarction

2005 ◽  
Vol 62 (9) ◽  
pp. 629-635
Author(s):  
Sasa Rafajlovski ◽  
Vjekoslav Orozovic ◽  
Goran Radjen ◽  
Andjelka Ristic-Andjelkov
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Right Ventricle ◽  
Coronary Angioplasty ◽  
Combined Therapy ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Mechanical Methods ◽  
Significant Difference ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal

Aim. To present the results and experience in diagnosing and treating of patients with acute right ventricle infarction, during the period of hospitalization of one month, with adjuvant analyses of the obtained results in the period of fifteen years. Methods. Acute right ventricle infarction porved clinicaly, enzymologicaly, by ECG, echochardiographically or scintigraphically we treated with thrombolitic therapy within first six hours after admittion, with salvaged PTA in case of the cardiogenic shock or AV block II??III? despite of thrommbolitic therapy, or with postponed PTA within first month of intrahospital treatment. Results. In the period from 1990 to 2004, 3 225 patients of both sexes were treated for acute myocardial infarction at the different localization in patients' at the mean age of 53.7 ? 5.8. One-hundredthirty - nine (43.9%) patients were treated with thrombolitic therapy according to the speed up protocole. Heparin was administered to 160 (50.7%) patients with water load, and 17 (5.4%) patients had the primary percutaneous transluminal coronary angioplasty (PPTCA), so that the mechanical blood flow could be established, by the implantation of a stent when necessary. In 316 patients with right ventricle infarction, 58 (18.3%) had postponed and salvaged percutaneous transluminal coronary angioplasty (PTCA). Twenty-two (15.8%) patients had thrombolitic therapy, whereas 36 (22.5%) patients were treated with heparin. We had a successful balloon dilatation in 21 (36.2%), whereas 32 (55.2%) patients had 1?3 intracoronary stents inplanted, depending upon the necessity, and 5 (8.6%) patients from this group were sent to surgical intervention. In the group of 214 (67.7%) patients treated with heparin or thrombolitic therapy combined therapy, with PTCA, 12 (5.7%) patients died, whereas in the group of 124 (39.3%) patients treated only with heparin 26 (16.2%) patients died, statistically significant difference (p < 0.001, ?2 = 18.423). Was noticed n the group of 1 204 patients with inferoposterior infarction, 122 (10.1% ) patients died. In the group of 316 patients with right ventricle infarction, 38 (12%) died. In the group of 888 control patients with inferoposterior infarction, but without right ventricle infarction, 84 (9.4%) patients died. In the group of 2 021 patients (62.2%) with anterior infarction, 248 (12.3%) died. Conclusion. The obtained results showed that the patients with right ventricle infarction, due to the great expansion of necrosis and the involvement of the inferoposterior wall of the left ventricle, as well as the ischemia of sinus and AV nodes, were the patients of a high risk. That was why it was essential to do urgent widening of the artery to reestablish blood flow either by using drugs or by means of mechanical methods.

scholarly journals Percutaneous transluminal coronary angioplasty in the right ventricle myocardial infarction treatment

2005 ◽  
Vol 62 (10) ◽  
pp. 731-738 ◽  
Author(s):  
Sasa Rafajlovski ◽  
Vjekoslav Orozovic ◽  
Andjelka Ristic-Andjelkov ◽  
Goran Radjen
Keyword(s):  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Right Ventricle ◽  
Coronary Angioplasty ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Heparin Therapy ◽  
Transluminal Coronary Angioplasty ◽  
The Right ◽  
Percutaneous Transluminal ◽  
Anterior Infarction

Background/Aim. To present the results of percutaneous transluminal coronary angioplasty (PTCA) in the treatment of the patients with acute right ventricle myocardial infarction (ARVMI), with adjuvant analyses of the obtained results in the period of five years (2000-2004). Methods. Thrombolytic therapy and the primary percutaneous transluminal coronary angioplasty (PPTCA) was applied within the first 6 hours from the onset of anginous disorders, and rescue PTCA in the period from 6?24 hours from the onset of ARVMI. Results. A total number of 1175 patients, both sexes, 763 (64.8%) males and 412 females (35.2%), mean age 58.4 ? 7.8 years, were treated for acute myocardial infarction (AIM) of different localization in the period of five years (2000-2004). Anterior infarction was found in 645 (54.8%) of the patients, and inferoposterior infarction (IPI) was localized in 530 patients (45.2%) patients of which in 134 (25.2%) AIMDK was proven. Out of 134 patients with proven acute myocardial of the right ventricle AIMDK, 53 (39.5%) got thrombolytic therapy, 64 patients (47.7%) were treated with the conservative heparin therapy, whereas in 17 patients (12.8%), primary percutaneous coronary angioplasty (PPTCA) was done. Delayed or rescue PTCA was done in 22 (18.8%) patients, in 8 (36.3%) from the group which got thrombolytic therapy, and in 14 (63.7%) treated with the heparin therapy. Out of the total number of 22 patients who got heparin or thrombolytic therapy combined with rescue PTCA, in 7 patients (31.8%) the complete clinical and angiographic effect of thrombolysis with AIM was achieved only by using a balloon. Baloon dilatation with the implantantion of intracoronary stent was performed in another 11 patients (50%), while 2 (9.1%) were sent to revascularization of the myocard due to diffusion changes in each of the 3 blood vessels, and 2 patients (9.1%) died. Of the patients, 17 (12.6%) had PPTCA with the implantation of intracoronary stent with the additional direct inhibitor of the platelet membrane glycoproteins IIb/IIIa (abciximab). All the patients treated in this way survived. They had no side effects nor serious complications. Their clinical recovery was satisfactory. In the first three weeks of the intrahospital period in the group of 45 patients (33.5%) with AIMDK, who got only thrombolytic therapy, 7 patients (15.5%) died, whereas in the group of 50 patients (37.3%) treated only with heparin, 13 (26%) died. In the group of 22 patients (18.8%) treated with the combined therapy with rescue PTCA and heparin or thrombolytic therapy, 2 patients (9.1%) died. In the group of 84 patients (62.6%) with AIMDK, who were treated with thrombolytic therapy with primary or rescue PTCA, 9 (10.7%) died. In the AIMDK group of 134 patients, 22 patients (16.4%) died in the period of 1 month of the hospital treatment, whereas in the second group of 396 patients with IPI, but without IDK, 36 (9.1%) died (?2 = 4.789; p < 0.001). Out of the total number of 1175 patients with AIM in the five-year period of the intrahospital treatment, 145 patients (12.3%) died. In the group of patients with IPI, 58 patients out of 530 (10.9%) died, whereas 87 patients out of 645 (13.4%) with anterior infarction died, (?2 = 0.567; p < 0.452). Conclusion. The combination of thrombolytic therapy and PTCA shown in the obtained results completely justified this kind of treatment, and offered the patients with AIMDK a greater chance to survey than they had before.

Comparison of Standard and Derived 12-Lead Electrocardiograms Registrated by a Simplified 3-Lead Setting with Four Electrodes for Diagnosis of Coronary Angioplasty-induced Myocardial Ischaemia

2012 ◽  
Vol 8 (3) ◽  
pp. 179 ◽  
Author(s):  
Klaus Bonaventura ◽  
Ernst Wellnhofer ◽  
Eckart Fleck ◽  
◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Ischaemia ◽  
Coronary Angioplasty ◽  
Patient Monitoring ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Myocardial Infarction Patient ◽  
Cardiovascular Patients ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal ◽  
Four Electrodes

Electrocardiograms (ECGs), myocardial infarction, patient monitoring, EASI lead ECG, percutaneous transluminal coronary angioplasty, four electrodes set 12-lead ECG, 12-lead ECG, cardiovascular patients

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