0236 : Epidemiological profile and prognostic factors of right myocardial infarction

Abstract

Myocardial infarction can affect any myocardial territory, however, the isolated right ventricle infarction is exceptional. It is often biventricular with a high mortality of about 30% compared to that of isolated LV (6%). To study the features epidemiological, clinical, diagnostic, therapeutic and prognostic of it. Retrospective and descriptive study conducted in the Cardiology department of UH Ibn Rochd of Casablanca. It was conducted on 13 patients admitted for acute MI extended to the RV, in the period April 2013 to March 2014. The average age of our patients was 58 years ranging from 39 to 71 years, with a male predominance (77% VS 13%). The majority of our patients (85%) have more than 03 cardiovascular risk factors. Chest pain with in physical examination: the jugular turgor, hypotension and bradycardia were the most common clinical signs in our patients. The ECG showed an ST-elevation in right leads (V3R, V4R) and in the lower area (DII, DIII and AvF) in all our patients. Dilatation of right cavities and wall motion disorders were the most frequent echocardiographic abnormalities (69% of patients). The most frequent complications were hemodynamic instability (54%) and rhythmic complications (38%). From the therapeutic point, thrombolysis was performed in 10 patients, which 06 received an additional angioplasty after failed thrombolysis. 07 patients required vascular filling, and inotropic drugs were used in 05 of our patients. Mortality in our series was 23%. Our series underscores the value of an early management of patients admitted to the acute phase of MI extended to RV, and the considerable contribution of thrombolysis as a means of revascularization and its positive impact on prognosis.