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

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 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 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 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 Correlation between Cardiac Biomarkers and Right Ventricular Dysfunction in Acute Inferior Wall Myocardial Infarction with and without Right Ventricular Myocardial Infarction

2020 ◽  
Author(s):  
Rajeev Bharadwaj ◽  
Ranjit Kumar Nath ◽  
Ashok Thakur ◽  
Bhagya Narayan Pandit ◽  
Dheerendra Kuber
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Troponin I ◽  
Statistical Significance ◽  
Group Versus ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Inferior Wall ◽  
Right Ventricular Myocardial Infarction ◽  
Echocardiographic Parameters

Introduction: Right Ventricular Myocardial Infarction (RVMI) along with inferior wall left ventricular (LV) dysfunction or Inferior Wall Myocardial Infarction (IWMI) is found in 30-50% of the cases. Isolated Right Ventricular (RV) dysfunction or infarction is rare except in iatrogenic (interventional) procedures. RVMI is being more commonly diagnosed retrospectively in the era of primary angioplasty, when these patients post-procedure fail to improve satisfactorily as compared to isolated IWMI patients. Clues to identify early RV involvement in acute IWMI patients will help in better management and less morbidity in this group of patients. Aim: The study was undertaken to search for any correlation between cardiac biomarkers {Troponin I (Trop I), Creatinine Kinase-MB (CK-MB), Brain Natriuretic Peptide (BNP)} and RV involvement using echocardiographic parameters in inferior Acute Myocardial Infarction (AMI), with and without associated RVMI, in patients who underwent primary Percutaneous Coronary Intervention (PCI). Materials and Methods: This was a cross-sectional study, conducted from September, 2018 to August, 2019, in the Cardiology Department of ABVIMS and Dr. Ram Manohar Hospital. A total of 294 patients, presenting with acute IWMI, were included in the study. Samples for Trop-I, CK-MB and BNP were taken immediately after admission. One hundred and thirty two patients had an associated RVMI. Two-dimensional Echocardiography was done within the first 12 hours of admission. Electrocardiography (ECG) and Echocardiography (EEG) assessments were used to determine RV involvement. Comparison was done first between patients with and without RV involvement, followed by comparison among groups for quantitative parameters, especially biomarkers, for finding correlation between biomarker levels and echocardiographic parameters (both RV and LV functions). Results: Patients presenting with IWMI with an associated RVMI had increased LV E/E’ ratio. Also, as predicted, they had a low Tricuspid Annulus Plane Systolic Excursion (TAPSE) and a low RV fractional area change, as well, due to stunning of right ventricle in the acute phase. In the group with higher BNP levels (≥400 pg/mL), the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/E’) was increased; on the other hand LV ejection fraction and TAPSE were decreased. There was negative correlation between RSm (RV systolic wave), TAPSE and BNP levels. BNP, Trop I and CK-MB levels showed a positive correlation with E/E’ at higher levels. Hypotension was more in patients presenting with RVMI, but it did not reach statistical significance. The mortality was 4.5% in the inferior Myocardial Infarction (MI) with RV involvement group versus 1.8% in isolated inferior MI group (during hospital stay). Conclusion: In acute Inferior wall MI, higher levels of BNP, CK-MB, Trop I, alone or in combination, might be used for prediction of RV involvement. BNP levels ≥400 pg/mL, Trop I levels ≥1.1 ng/mL, and CK-MB levels ≥4.5 ng/mL, along with hypotension and higher E/E’ ratio were observed in such cases and were associated with RV dysfunction and increased mortality.

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
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