Jugular venous pressure and pulse wave form in the diagnosis of right ventricular infarction

Mittal, S.R.; Garg, Sandeep; Lalgarhia, Mahesh

doi:10.1016/0167-5273(95)02550-2

Cited by 16 publications

(7 citation statements)

References 23 publications

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“…in our study specificity was 95. 24% and sensitivity was 64%, and these results were supported by Mittal et al (1996), who reported that raised jugular venous pressure had high specificity (96.8%) but low sensitivity (39%) in diagnosing RV infarction [14].…”

Section: Discussionsupporting

confidence: 73%

“…The in-hospital mortality rate for IWMI with RV infarction is 31% compared to 6% in IWMI without RVMI [12]. The mortality of cardiogenic shock due to right ventricular infarction (55%) was comparable to that due to left ventricular infarction (59%) in spite of patients being younger and having a higher incidence of single vessel disease [13]. Observational studies have suggested that early reperfusion in inferior wall MI with RV infarction is beneficial.…”

Section: Discussionmentioning

confidence: 88%

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Accuracy of Clinical Symptoms, Electrocardiographic and Echocardiographic Parameters for Diagnosis of Significant Proximal Right Coronary Artery Lesion in Acute Inferior Wall Myocardial Infarction

Shetaya

Elkhashab

Razek

2016

ICFJ

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IntroductionRight ventricular (RV) infarction is one of the major causes of RV contractile dysfunction. RV involvement occurs in 20-50% of inferior infarctions [1]. Patients with RV infarction associated with inferior infarction have much higher rates of significant hypotension, bradycardia requiring pacing, and in-hospital mortality compared to isolated inferior infarction [2] Occlusion of proximal dominant RCA is usually responsible for RV infarction in inferior wall myocardial infarction [3] Results: There were 35 patients with first episode of IWMI, group A (n =14 patients) and group B (n =21patients), There were significant differences between groups in TAPSE (1.28cm vs 1.98 p < 0.001), MPI-TDI (0.69±0.12 vs 0.38±0.05 p < 0.001), and in S'velocity from RV free wall ( 0.09m/s±0.02 vs 0.12m/s ±0.02 p < 0.001). It was found that S'<10cm/s is a predictor of proximal RCA lesion with sensitivity of 92.86% and specificity of 85.71%, ppv 81.25, npv 94.74. MPI-TDI>0.55 had a sensitivity of 92.86 % and a specificity of 100%, 100% PPV and 95.45% NPV. TAPSE<16mm had a sensitivity of 93%, and a specificity of 100%. Conclusion: RV indices (S' velocity, MPI-TDI and TAPSE ) are useful in predicting proximal RCA as infarct related artery in IWMI.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 88%

Accuracy of Clinical Symptoms, Electrocardiographic and Echocardiographic Parameters for Diagnosis of Significant Proximal Right Coronary Artery Lesion in Acute Inferior Wall Myocardial Infarction

Shetaya

Elkhashab

Razek

2016

ICFJ

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“…At the time of presentation, there were no significant differences in hemodynamics, left ventricular, ejection fraction, and RV dimension between patients with proximal and distal RCA lesions. This can be explained by the fact that RVMI can lead to various degrees of myocardial ischemia and does not always lead to hemodynamic impairment [28], [29]. Furthermore, there was no significant difference in RVSP derived from TR between patients with proximal versus distal RCA stenosis.…”

Section: Discussionmentioning

confidence: 99%

Right ventricular echocardiographic parameters for prediction of proximal right coronary artery lesion in patients with inferior wall myocardial infarction

Sebaie

Elkhateeb

2016

Journal of the Saudi Heart Association

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“…If the atrial perfusion is not compromised, the a-wave and x descend waveforms of the JVP are enhanced but y descent is blunted due to pandiastolic RV dysfunction, giving rise to a ‘W’ pattern waveform 47–49. In patients with associated RA infarction, the RA and central venous pressures are higher but with depressed a-wave, and x and y descent, forming an ‘M’ pattern 48. Dilatation of the RV may lead to functional tricuspid regurgitation such that the RA pressure tracing reveals a systolic wave that precedes and may fuse with the venous filling wave 50.…”

Section: Diagnosis Of Rvmimentioning

confidence: 99%

Right ventricular myocardial infarction: pathophysiology, diagnosis, and management

Kakouros

Cokkinos

2010

Postgraduate Medical Journal

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Right ventricular (RV) ischaemia complicates up to 50% of inferior myocardial infarctions (MIs), though isolated RV myocardial infarction (RVMI) is extremely rare. Although the RV shows good long term recovery, in the short term RV involvement portends a worse prognosis to uncomplicated inferior MI, with haemodynamic and electrophysiologic complications increasing in-hospital morbidity and mortality. Acute RV shock has an equally high mortality to left ventricular (LV) shock. Identification of RV involvement, particularly in the setting of hypotension, can help anticipate and prevent complications and has important management implications which are distinct from the management of patients presenting with LV infarction. Reperfusion therapy, particularly by primary percutaneous coronary intervention, hastens and enhances RV functional recovery that occurs to near normality in most patients. The diagnostic methods for RVMI are discussed, including clinical, electrocardiographic, and various imaging modalities as well as the RV pathophysiology that underpins the specifics of RVMI management.

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Jugular venous pressure and pulse wave form in the diagnosis of right ventricular infarction

Cited by 16 publications

References 23 publications

Accuracy of Clinical Symptoms, Electrocardiographic and Echocardiographic Parameters for Diagnosis of Significant Proximal Right Coronary Artery Lesion in Acute Inferior Wall Myocardial Infarction

Accuracy of Clinical Symptoms, Electrocardiographic and Echocardiographic Parameters for Diagnosis of Significant Proximal Right Coronary Artery Lesion in Acute Inferior Wall Myocardial Infarction

Right ventricular echocardiographic parameters for prediction of proximal right coronary artery lesion in patients with inferior wall myocardial infarction

Right ventricular myocardial infarction: pathophysiology, diagnosis, and management

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