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