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Acute right ventricular myocardial infarction.
Journal article

Acute right ventricular myocardial infarction.

  • Albulushi A a Cardiovascular Division , University of Nebraska Medical Center , Omaha , NE , USA.
  • Giannopoulos A b Cardiac Imaging, Department of Nuclear Medicine , University Hospital Zurich , Zurich , Switzerland.
  • Kafkas N c Cardiology Department , General Hospital KAT , Athens , Greece.
  • Dragasis S c Cardiology Department , General Hospital KAT , Athens , Greece.
  • Pavlides G a Cardiovascular Division , University of Nebraska Medical Center , Omaha , NE , USA.
  • Chatzizisis YS a Cardiovascular Division , University of Nebraska Medical Center , Omaha , NE , USA.
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  • 2018-06-15
Published in:
  • Expert review of cardiovascular therapy. - 2018
Right ventricle
myocardial infarction
prognosis
revascularization
Coronary Angiography
Echocardiography
Electrocardiography
Heart Ventricles
Heart-Assist Devices
Hemodynamics
Humans
Magnetic Resonance Imaging
Myocardial Infarction
Prognosis
Shock, Cardiogenic
English Acute right ventricular myocardial infarction (RVMI) is observed in 30-50% of patients presenting with inferior wall myocardial infarction (MI) and, occasionally, with anterior wall MI. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps, and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography, and coronary angiography, whereas noninvasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role. Early revascularization, percutaneous or pharmacological, represents key step in the management of RMVI. Maintenance of reasonable heart rate and atrioventricular synchrony is essential to sustain adequate cardiac output in these patients. When conventional treatment is not successful, mechanical circulatory support, including right ventricle assist devices, percutaneous cardiopulmonary support, and intra-aortic balloon pump, might be considered. The prognosis associated with RVMI is worse in the short term, compared to non-RVMI, but those patients who survive hospitalization have a relatively good long-term prognosis.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/197466
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