The spectrum of right ventricular involvement in inferior wall myocardial infarction: A clinical, hemodynamic and noninvasive study

Baigrie, Ronald S.; Haq, Aminul; Morgan, Christopher D.; Rakowski, Harry; Drobac, Milutin; McLaughlin, Peter R.

doi:10.1016/s0735-1097(83)80042-4

Cited by 79 publications

(9 citation statements)

References 29 publications

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“…Since then, several studies have validated the usefulness of volume loading for ischaemic RV dysfunction. [40][41][42][43] Therefore, the initial therapy for hypotension in patients with RV infarction without pulmonary congestion has traditionally been volume expansion, particularly if the estimated central venous pressure was <15 mmHg. 44 In previous studies, maintenance of the RV preload with volume loading and normal saline alone was thought to resolve the accompanying hypotension and improve the cardiac output.…”

Section: Volume Replacementmentioning

confidence: 99%

The challenges in the management of right ventricular infarction

Inohara

Kohsaka

Fukuda

et al. 2013

European Heart Journal: Acute Cardiovascular Care

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In recent years, right ventricular (RV) infarction seems to be underdiagnosed in most cases of acute myocardial ischaemia despite its frequent association with inferior-wall and, occasionally, anterior-wall myocardial infarction (MI). However, its initial management is drastically different from that of left ventricular MI, and studies have indicated that RV infarction remains associated with significant morbidity and mortality, even in the mechanical reperfusion era. The pathophysiology of RV infarction involves the interaction between the right and left ventricle (LV), and the mechanism has been clarified with the advent of diagnostic non-invasive modalities, such as echocardiography and cardiac magnetic resonance. In recent years, considerable progress has been made in the treatment of RV infarction; early revascularization remains the cornerstone of the management, and fluid resuscitation, with appropriate target selection, is necessary to maintain appropriate preload. Early recognition in intensive care with clear understanding of the pathophysiology is essential to improve its prognosis. In terms of management, the support strategy for RV dysfunction is different from that for LV dysfunction since the former may often be temporary. Along with early reperfusion, maintenance of an adequate heart rate and atrioventricular synchrony are essential to sustain a sufficient cardiac output in patients with RV infarction. In refractory cases, more intensive mechanical support is required, and new therapeutic options, such as Tandem-Heart or percutaneous cardiopulmonary support systems, are being developed.

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Section: Volume Replacementmentioning

confidence: 99%

The challenges in the management of right ventricular infarction

Inohara

Kohsaka

Fukuda

et al. 2013

European Heart Journal: Acute Cardiovascular Care

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“…W przypadku stwierdzenia niedomykalności trójdzielnej można również dokonać pomiaru ciśnienia skurczowego w PK. U chorych z zawałem PK obserwuje się także paradoksalny ruch przegrody międzykomorowej [13,14].…”

Section: Nieinwazyjne Metody Diagnozowania Zawału Prawej Komoryunclassified

Right ventricular infarction in cardiovascular magnetic resonance

Kwieciński¹,

Kociemba²,

Siniawski³

et al. 2011

pwki

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223Zawał prawej komory serca w obrazowaniu metodą rezonansu magnetycznego Right ventricular infarction in cardiovascular magnetic resonance J Ja ac ce ek k K Kw wi ie ec ci iń ńs sk ki i 1 1 , , A An nn na a K Ko oc ci ie em mb ba a 1 1 , , A An nd dr rz ze ej j S Si in ni ia aw ws sk ki i 1 1, ,2 2 , , M Ma ag gd da al le en na a J Ja an nu us s 1 1, ,2 2 , , M Ma ag gd da al le en na a Ł Ła an no oc ch ha a 1 1, ,2 2 , , S St te ef fa an n G Gr ra aj je ek k 2 2 , , K Ka at ta ar rz zy yn na a K Ka ar rm me el li it ta a--K Ka at tu ul ls sk ka a 1 1 , , M Ma ał łg go or rz za at ta a P Py yd da a 1 1, ,2 2

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“…73 Although highly specific, technetium-99m pyrophosphate scintigraphy is not very sensitive, especially for detecting hemodynamically important RVI. The sensitivity of this method to detect this clinically important presentation of RVI approaches 25%.22 Also, application of this technique is limited in the acute setting because scans should be obtained 24 to 36 h after the onset of the infarct.…”

Section: Technetium-99m F'ymphosphate Scintigrammentioning

confidence: 99%

Right ventricular infarction—diagnosis and treatment

Haji

Movahed

2000

Clinical Cardiology

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Summary: Right ventricular infarction (RVI) as assessed by various diagnostic methods accompanies inferior-posterior wall myocardial infarction (MI) in 30 to 50% of patients. Recognition of the syndrome of RVI is important as it defines a significant clinical entity, which is associated with considerable immediate morbidity and mortality and has a well-delineated set of priorities for its management. Patients may clinically present with hypotension, elevated jugular venous pulse (JVP), and occasionally shock, all in the presence of clear lung fields. The ST-segment elevation of 2 0.1 mV in the right precordial leads V4R is a readily available electrocardiographic sign used for diagnosis of RVI. Other diagnostic approaches for assessing RVI include echocardiography, radionuclide ventriculography, technetium pyrophosphate scanning, and hemodynamic measurements. The proper management of RVI includes volume loading to maintain adequate right ventricular preload, ionotropic support, and maintenance of atrioventricular synchrony. Reperfusion therapy should be initiated at the earliest signs of right ventricular dysfunction. Finally, complete recovery over a period of weeks to months is a rule in a majority of patients, suggesting right ventricular "stunning" rather than irreversible necrosis has occurred.

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The spectrum of right ventricular involvement in inferior wall myocardial infarction: A clinical, hemodynamic and noninvasive study

Cited by 79 publications

References 29 publications

The challenges in the management of right ventricular infarction

The challenges in the management of right ventricular infarction

Right ventricular infarction in cardiovascular magnetic resonance

Right ventricular infarction—diagnosis and treatment

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