A Case of Electrical Right-Ventricular Infarction in the Absence of Clinical Right-Ventricular Failure

Kay, Robert; O’Neill, Blair J.; Taylor, Dylan; Senaratne, Janek

doi:10.1016/j.cjco.2021.11.005

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…This relative resistance to ischemic dysfunction and injury might be explained by some of RV perfusion characteristics such as perfusion throughout the entire cardiac cycle caused by lack of mechanical inhibition to perfusion during contraction, lower baseline oxygen demand due to lower developed systolic pressure, and less wall stress, and higher oxygen extraction reserve [6]. Furthermore, we propose the collateral flow from the left coronary system further protects us from RV dysfunction in our patient [7].…”

Section: Discussionmentioning

confidence: 77%

Isolated Right Ventricular Infarction without Right Ventricular Dysfunction: A Case Report

Wening,

Siagian,

Asanti

et al. 2023

SEE J Cardiol

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BACKGROUND: Myocardial infarction is the leading cause of the occlusion of the coronary artery. Meanwhile, right ventricular myocardial infarction (RVMI) is usually associated with inferior left ventricular infarction in 10–50% of cases. We presented isolated RV infarcts which are rare cases that happen in only 3% of total myocardial infarction. CASE PRESENTATION: We presented a case of a 67-year-old man with sudden chest pain, shortness of breath, and a history of diabetes mellitus. From his 12 lead electrocardiogram, there is no specific ST elevation yet elevation in V3R and V4R and elevated troponin I highly sensitive value. The patient developed junctional bradycardia and early percutaneous coronary intervention backup temporary pacemaker showed total occlusion in the proximal right coronary artery (RCA) CONCLUSION: The RVMI commonly occurs in the dominant RCA that also supplies the sinoatrial node and atrioventricular node. Therefore, due to its location that passed through the RCA, bradycardia to complete heart block may happen. Isolated right ventricular (RV) infarction may happen because either RV marginal as the predominant location is occluded, or non-dominant RCA occluded by thrombus. RV infarction may impair RV contractility causing a decrease in RV stroke volume and this condition leads to hypotension, shock, and severe hemodynamic derangement. Meanwhile, acute proximal RCA occlusions do not result in significant RV necrosis, one of the reasons is collateral flow from the left coronary system further protects from RV dysfunctions in our patient.

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Section: Discussionmentioning

confidence: 77%