Diagnostic value of standard electrocardiogram in acute right ventricular myocardial infarction

Abstract

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 (RCA) (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 (AMI) helps detect more invasive patients and prevents extensive myocardial damage and other complications.

Fluorescent Immunoassays for Detection and Quantification of Cardiac Troponin I: A Short Review

“…One of the most life-threatening events of this blockage of arteries is acute myocardial infarction (MI) ("heart attack") which could cause irreversible damage to the heart tissues. Electrocardiography (ECG) is usually the diagnostic tool for MI [3], however, more than 40% of MI cases show normal ECG when admitted to the emergency room. Additionally, in many cases, MI is asymptomatic without any apparent chest pain or shortness of breath leading to an even lower chance of being diagnosed directly [4].…”

Diagnostic difficulties of isolated right ventricular myocardial infarction

“…Тем не менее заподозрить поражение ПЖ было возможно, поскольку на первой ЭКГ через 12 часов после начала заболевания сохранялись зубцы R в правых грудных отведениях, что не характерно для инфаркта передней локализации. Между тем подъем сегмента ST в правых грудных отведениях может отмечаться не только при переднем, но и при нижнем инфаркте с поражением ПЖ [8][9][10], а также при изолированном ИМПЖ [6,7]. В этих случаях подъем сегмента ST в правых грудных отведениях отражает потенциал повреждения не передней части межжелудочковой перегородки, а свободной стенки ПЖ.…”

Clinical outcomes and complications of treatment with supraflex stent in patients with coronary artery disease: One-year follow-up

“…Cardiovascular disease is one of the most important causes of morbidity and mortality in the world, 1 and in Iran. 15 Treatment is often a percutaneous coronary intervention. The new generation of stents is the Sirolimus Eluting stent.…”