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Right Ventricular Infarction in Patients with Acute Inferior Myocardial Infarction | ||
| Kerbala Journal of Medicine | ||
| Article 6, Volume 1, Issue 1, 2007, Pages 145-149 PDF (0 K) | ||
| Author | ||
| Ahmed H. Al-Myali | ||
| Abstract | ||
| Abstract Background: Right ventricular infarction (RVI) complicating inferior wall myocardial infarction (IWMI) is common. Electrocardiogram (ECG) through right pericordial leads (V4R) is a useful & convenient toll of diagnosing RVI. Objectives: To study the frequency of occurrence of RVI in patients with IWMI using the standard ECG through right precordial lead (V4R), to define the risk factors for its occurrence and to identify the associated physical signs & other ECG abnormalities. Patients & methods: 90 patients admitted to the coronary care unit (CCU) were studied, we assessed the prevalence of (RVI) using the right precordial lead (V4R), risk factors for its occurrence & other important physical signs & ECG finding. Results: RVI was diagnosed in (28.9%) of patients with IWMI, defined by the presence of o.1 mm ST-segment elevation in V4R. Increasing age, diabetes mellitus (DM) & smoking were significantly associated risk factors. Atrioventricular block (AV block) occurred in 23% patients with RVI compared to 10.9% in patients with isolated IWMI. The classical triad of hypotension raised jugular venous pressure & absence of rales on chest auscultation occurred in 7.9% of patients with RVI compared to none of patients with isolated IWMI. Hypotension following the administration of morphine & nitroglycerin were found in 66.6% of patients with RVI compared to non of patients with isolated IWMI. Conclusion: Standard surface ECG by using V4R could aid clinical recognition of concomitant RVI in patients with IWMI. Hypotension following the administration of anti-ischemic medications & atrioventricular block (AV block) were more common in patients with RVI. Increasing age, male sex diabetes mellitus & previous history of ischemic heart disease were risk factors for the occurrence of | ||
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