Study of inferior myocardial infarction extended to the right ventricle: Series of 100 cases

Abstract

Ischemic heart disease is a common cause of morbidity and mortality worldwide. Acute inferior wall myocardial infarction accounts for 40% all acute myocardial infarctions. Acute coronary syndromes involving the right side of the heart are associated with increased mortality, a complex clinical course, and lengthy hospitalization, as well as with frequent mechanical and electrical complications. To study the incidence, clinical, therapeutic and angiographic profile of right ventricular (RV) infarction and inferior wall myocardial infarction. One hundred cases of inferior wall infarction were included in the study. Patients with history of previous infarction, bundle branch block, and suspected pulmonary embolism were excluded. Incidence of right ventricular infarction is about 25% in inferior wall myocardial infarction. Most patients presented with retrosternal chest pain associated with sweating. Male constituted 79.62% of the population studied. Smoking is the main cardiovascular risk factor found in 57.28% of cases. Diabetes and hypertension are present in 38% and 25% of cases respectively. Right ventricular failure was present in 23% of patients. The group with RV infarction has more conduction disorders (32% vs 6%). The right coronary artery (RCA) was responsible for the RV infarction in 100%. However, Acute inferior wall myocardial infarction is secondary of RCA in 56% and circumflex in 44%. RV infarction is common in patients with acute inferior wall myocardial infarction. Rapid detection of RV infarction and the early treatment even for patients without hypotension or cardiogenic shock is important to improve the prognosis.