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.

scholarly journals Acute Isolated Right Ventricular Infarction: Unusual Presentation of Anterior ST-Segment-Elevation Myocardial Infarction

2019 ◽  
Vol 46 (2) ◽  
pp. 151-154
Author(s):  
Wayne W. Zhong ◽  
Matthew Blue ◽  
Andrew D. Michaels
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Right Coronary Artery ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
St Segment ◽  
Right Ventricular Myocardial Infarction ◽  
Ventricular Infarction ◽  
Electrocardiographic Leads

Acute right ventricular infarction presenting with ST-segment elevation in the anterior precordial electrocardiographic leads is an unusual event. Anterior ST-segment elevation typically suggests occlusion of the left anterior descending coronary artery. It should be recognized, however, that occlusion of a right coronary artery branch can cause isolated ST-segment elevation in leads V1 and V2 on a standard 12-lead electrocardiogram. We describe the cases of 2 patients who presented with acute chest syndrome with isolated ST-segment elevation in leads V1 and V2. Emergency coronary angiograms revealed that acute thrombotic occlusion of the right ventricular marginal branch of the dominant right coronary artery caused the clinical manifestations in the first patient, whereas occlusion of the proximal nondominant right coronary artery was the culprit lesion in the second patient. Both lesions caused right ventricular myocardial infarction. The patients underwent successful primary percutaneous coronary intervention. These cases illustrate the importance of carefully reviewing angiographic findings to accurately diagnose an acute isolated right ventricular myocardial infarction, which may mimic the electrocardiographic features of an anterior-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 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 Acute myocardial infarction with ST segment elevation in inferior and anterior leads: right ventricular infarction

2010 ◽  
Vol 2010 (feb02 1) ◽  
pp. bcr0320091700-bcr0320091700
Author(s):  
R. Berent ◽  
J. Auer ◽  
S. von Duvillard ◽  
H. Sinzinger ◽  
D. Steinbrenner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Right Ventricular ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
St Segment ◽  
Ventricular Infarction

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 Qrs-Complex Fragmentations and Right Ventricular Infarction in the Presence of Inferior Infarction with Triple-Vessels Disease; Bad Initials but a Good Outcome

2022 ◽  
Vol 3 (1) ◽  
pp. 01-04
Author(s):  
Yasser Mohammed Hassanain Elsayed
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Heavy Smoker ◽  
Qrs Complex ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Ventricular Infarction

Rationale: The term “fragmentation of the QRS complex” denotes the existence of high-frequency potentials (spikes) in the QRS-complex. It is either a marker for cardiac structural diseases inducing biventricular hypertrophy or any condition interfering with the normally homogeneous depolarization status inside the myocardium. An associated right ventricular infarction with inferior infarction maybe carry a risk impact and serious complications. Patient concerns: A 64-year-old married, farmer, heavy smoker, Egyptian male patient presented with acute severe chest pain and inferior with right ventricular ST-segment elevation myocardial infarction and fragmentation of the QRS complex. Diagnosis: QRS-complex fragmentations and right ventricular infarction in the presence of inferior infarction with the triple-vessels disease. Interventions: Electrocardiography, oxygenation, streptokinase intravenous infusion, echocardiography, and percutaneous transluminal coronary angioplasty. Outcomes: Dramatic response of acute inferior with right ventricular ST-segment elevation myocardial infarction and QRS-complex fragmentations to streptokinase. Lessons: Despite the presence of inferior and right ventricular ST-segment elevation myocardial infarction with QRS-complex fragmentations, but there is no correlation with the severity of the disease. Dramatic clinical and electrocardiographic response signifying the role of streptokinase and fibrinolytic. The presence of fragmentation of the QRS-complex may have a bidirectional impact from seriousness to complications.

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