The Right-Sided Electrocardiogram for Right Ventricular Myocardial Infarction

2019 ◽  
Vol 5 (6) ◽  
pp. 245-245
Author(s):  
Pradnya Brijmohan Bhattad ◽  
◽  
Vinay Jain ◽  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Right Ventricular Myocardial Infarction ◽  
The Right

scholarly journals Clinical Outcome and Echocardiographic Evaluation of Inferior Myocardial Infarction with Right Ventricular Involvement

2012 ◽  
Vol 4 (2) ◽  
pp. 132-138 ◽  
Author(s):  
B Guha ◽  
AAS Majumder ◽  
MNA Chowdhury ◽  
MM Hossain ◽  
AK Mandal
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Clinical Signs ◽  
Cost Effective ◽  
Risk Groups ◽  
Inferior Wall ◽  
Right Ventricular Myocardial Infarction ◽  
Ventricular Infarction ◽  
Severity Of The Disease ◽  
The Right

Background : Acute right ventricular myocardial infarction complicates inferior wall myocardial infarction with an incidence of 14-84%. ECG is the cornerstone in initial diagnosis as it is cost effective and done easily. Echocardiographic analysis of the right ventricular involvement can shed light on the severity of the disease. Hence we aimed to study right ventricular infarction in acute inferior wall myocardial infarction using right precordial lead as well as echocardiography. Methods: Present study is based on the analysis of 100 patients admitted to Coronary care unit of the National Institute of Cardiovascular Diseases & Hospital during July 2010 to June 2011, with acute inferior wall myocardial infarction. 12 lead ECG with thorough physical examination was done along with right precordial mapping. ST ³ 1mm in V4R was initial diagnostic of right ventricular involvement followed by echocardiographic assessment of RV and LV within 24 hours. Results: A total of 50 patients showed right ventricular involvement with V4R being the sensitive lead. Echocardiography showed mean RVEF of patients with 29.5 % ± 9.5 in comparison of 44.9%±12.2 without right ventricular involvement. Right ventricular involvement presented with bradycardia (40%) and hypotension, 80% Kussmaul’s sign, 14% with complete heart block. Mortality in right ventricular involvement was 6 times higher than without right ventricular involvement (12 %). Conclusion: Clinical signs and symptomatology are not fully diagnostic of RVI in inferior wall acute MI. ECG can diagnose (using right precordial mapping) this condition very early. Echocardiography help to assess the right ventricular function high-risk groups for aggressive management like primary PCI. Early diagnosis will help in careful monitoring and management of such cases. DOI: http://dx.doi.org/10.3329/cardio.v4i2.10457 Cardiovasc. j. 2012; 4(2): 132-138

Diagnostic difficulties of isolated right ventricular myocardial infarction

Kardiologiia ◽  
2021 ◽  
Vol 61 (9) ◽  
pp. 66-70
Author(s):  
N. S. Kuznetsova ◽  
R.  M. Rabinovich ◽  
V. V. Mazur ◽  
E. S. Mazur
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Blood Supply ◽  
Right Ventricular Myocardial Infarction ◽  
Diagnostic Difficulties ◽  
Heart Blood ◽  
The Right ◽  
Proximal Occlusion

The article describes a case of isolated right ventricular myocardial infarction induced by proximal occlusion of the right coronary artery in a patient with the left type of heart blood supply. A specific feature of the case was detection of the McConnell’s sign, which is considered characteristic of pulmonary artery thromboembolism. 

scholarly journals Right Ventricular Longitudinal Strain in Acute Pulmonary Embolism and Right Ventricular Myocardial Infarction in Patients with McConnell’s Sign

Kardiologiia ◽  
2020 ◽  
Vol 60 (7) ◽  
pp. 20-27
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
R. M. Rabinovich ◽  
K. S. Myasnikov
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Interventricular Septum ◽  
Cutoff Point ◽  
Apical Segment ◽  
Chamber View ◽  
Right Ventricular Myocardial Infarction ◽  
The Right

Aim      To study the right ventricular (RV) myocardial longitudinal systolic strain in patient with RV myocardial infarction (MI), and pulmonary embolism (PE) with and without McConnell’ phenomenon.Material and methods  This study included 53 patients with PE (mean age, 59.0±15.1 years; men, 58.5 %) and 30 patients with RVMI (mean age, 61.8±10.9 years; men, 90 %). Longitudinal strain of basal, medial and apical segments of the RV free wall (RVFW) and the interventricular septum (IVS) was determined in the mode of two-dimensional speckle tracking. Ratio of the IVS apical strain to the RVFW strain (apical ratio) was calculated. Systolic excursion of the RVFW apical segment (apical excursion) was measured in the anatomical M-mode from the apical four-chamber view.Results The McConnell’s sign was observed in 23 (43.4 %) of 53 patients with PE and in 16 (53.3 %) of 30 patients with RVMI (p>0.05). Irrespective of the cause for the RV damage, patients with the McConnell’s sign had higher values of the apical ratio (1.69±0.50 vs. 0.95±0.22; p<0.001; cutoff point, 1.18) and apical excursion (7.9±1.7 vs. 2.6±1.4 mm; p<0.001; cutoff point, 5.0 mm). Apical excursion closely correlated with the value of apical ratio (r=0.65; p<0.001) but not with the RVFW apical segment strain (r= –0.07; p>0.05).Conclusion      Incidence of the McConnell’s sign was similar in patients with PE and RVMI. McConnell’s sign is based on a passive systolic shift of the RVFW apical segment, which develops during contraction of the IVS apical segment. The greater the ratio of IVS apical segment to RBFW global strain the greater the amplitude of this shift. With the ratio value of 1.18 or more, the systolic shift of RVFW apical segment was >5 mm, which was visually perceived as the McConnell’s sign. 

scholarly journals The Efficacy of Thrombolytic Therapy in Inferior Myocardial Infarction with Damage to the Right Ventricular

2021 ◽  
Vol 17 (2) ◽  
pp. 233-238
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
N. S. Kuznetsova ◽  
R. M. Rabinovich ◽  
K. S. Myasnikov
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Thrombolytic Therapy ◽  
Right Ventricular ◽  
False Positive ◽  
Inferior Myocardial Infarction ◽  
St Segment ◽  
Right Ventricular Myocardial Infarction ◽  
Medial Segment ◽  
The Right

Aim. To study the results of thrombolytic therapy and accuracy of electrocardiographic assessment of thrombolysis efficiency in inferior myocardial infarction with and without right ventricular lesion.Material and methods. The118 patients with inferior myocardial infarction were included in this study. They received TLT in the first 12 hours of the disease. The dynamics of ST-segment in 90 minutes from the TLT start and coronary angiography data were analyzed.Results. Right ventricular myocardial infarction (RVMI) was diagnosed in 49 (41.5%) of 118 patients by echocardiography. Patients with and without RVMI did not differ in age, gender and comorbidities, but patients with RVMI were more likely to have arterial hypotension, atrioventricular block, and atrial fibrillation. All patients with RVMI had occlusion of the right coronary artery (RCA) in the proximal (34.7%) or medial segment (65.3%). Occlusion of the circumflex coronary artery was found in 20 (29.0%) patients without RVMI, and RCA occlusion - in other patients. The infarction-associated artery blood flow equal TIMI 2-3 was found in 17 (34.7%) patients with RVMI and in 46 (66.7%) patients without RVMI (p<0.005). ST-segment decrease by 50% or more in 90 minutes from the TLT was found in 35 (71.4%) patients with RVMI and in 49 (71.0%) patients without RVMI (p>0.05). The false-positive assessment of thrombolysis efficiency was noted in patients with and without RVMI in 21 (42.9%) and 11 (15.9%) cases (p <0.005), respectively. There were no false-positive assessments in patients with RVMI when using ST-segment decrease to the isoline.Conclusion. TLT should be considered effective in patients with inferior myocardial infarction with the right ventricle lesion, if ST-segment decreases to isoline in 90 minutes from the TLT start.

scholarly journals А new electrocardiographic criterion in diagnosis right ventricular myocardial infarction

2021 ◽  
Vol 22 (3) ◽  
pp. 24-31
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
R. M. Rabinovich ◽  
N. S. Kuznetsova ◽  
K. S. Myasnikov
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Predictive Value ◽  
Inferior Myocardial Infarction ◽  
Negative Results ◽  
St Segment ◽  
Right Ventricular Myocardial Infarction ◽  
Surface Ecg ◽  
Ventricular Infarction ◽  
The Right

The aim of this study is to identify the features of ST-changes in 12-leads surface ECG, which help to diagnose the right ventricular involvement in inferior myocardial infarction. The study included 145 patients with inferior myocardial infarction, the right ventricular infarction (RVI) was detected by echocardiography in 62 (42.8%) patients. ST segment depression in lead aVL was deeper than in lead V3 in 93.5% of patients with RVI. This feature is revealed in 4.9% patients with inferior myocardial infarction without RVI only. The sensitivity of this criterion for diagnosis RVI is 93.5%, the specificity is 95.2%, the predictive value of positive and negative results make up 93.5 and 95.2%.

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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