Acute Isolated Right Ventricular Infarction
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PROVIDER: S-EPMC10865139 | biostudies-literature | 2023 Dec
REPOSITORIES: biostudies-literature
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Project description:BackgroundIsolated right ventricular myocardial infarction (RVMI) due to a recessive right coronary artery (RCA) occlusion is a rare presentation. It is typically caused by right ventricle (RV) branch occlusion complicating percutaneous coronary intervention. We report a case of an isolated RVMI due to flush RCA occlusion presenting via our primary percutaneous coronary intervention ST-elevation myocardial infarction pathway.Case summaryA 61-year-old female smoker with a history of hypercholesterolaemia presented via the primary percutaneous coronary intervention pathway with sudden onset of shortness of breath, dizziness, and chest pain while walking. Transradial coronary angiography revealed a normal left main coronary artery, large left anterior descending artery that wrapped around the apex and dominant left circumflex artery with the non-obstructive disease. The RCA was not selectively entered despite multiple attempts. The left ventriculogram showed normal left ventricle (LV) systolic function. She was in cardiogenic shock with a persistent ectopic atrial rhythm with retrograde p-waves and stabilized with intravenous dobutamine thus avoiding the need for a transcutaneous venous pacing system. A computed tomography pulmonary angiogram demonstrated no evidence of pulmonary embolism while an urgent cardiac gated computed tomography revealed a recessive RCA with ostial occlusive lesion. A cardiac magnetic resonance imaging confirmed RV free wall infarction. She was managed conservatively and discharged to her local district general hospital after 5th day of hospitalization at the tertiary centre.DiscussionThis case describes a relatively rare myocardial infarction presentation that can present with many disease mimics which can require as in this case, a multi-modality imaging approach to establish the diagnosis.
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Project description:Here, we report a case of ventricular septal perforation complicated with right ventricular infarction after inferior acute myocardial infarction, which was associated with a poor clinical outcome despite the successful surgical treatment.
| S-EPMC10577155 | biostudies-literature
Project description:Isolated right ventricular (RV) infarction is extremely rare and its diagnosis may be challenging, because RV infarction most often occurs simultaneously with infarction of the inferior wall of the left ventricle. A 66-year-old man with a history of diabetes mellitus presented with cold sweat and general malaise. Although his symptoms were atypical for myocardial infarction, he was quickly diagnosed with RV infarction and successfully underwent urgent percutaneous coronary intervention. He was definitely diagnosed with isolated RV infarction by a scintigram and cardiac magnetic resonance imaging. Our review showed the importance of the combined assessment in the diagnosis of isolated RV infarction.
| S-EPMC8907765 | biostudies-literature
Project description:Isolated right ventricular myocardial infarction is an extremely rare condition, and its diagnosis may be challenging. We present the case of a 63-year-old man who arrived at the emergency department with chest pain; electrocardiogram showed ST-segment elevation in precordial leads, for which, the diagnosis of anterior ST-elevation myocardial infarction was initially made. Coronary angiography showed diffuse coronary artery ectasia and total thrombotic occlusion of the right coronary artery that was treated by angioplasty and stenting, resulting in resolution of the chest pain and ST-segment elevation. Echocardiogram showed right ventricular systolic dysfunction and cardiac magnetic resonance confirmed the diagnosis of isolated right ventricular myocardial infarction. We highlight the value of invasive and non-invasive tests to diagnose this rare condition. <Learning objective: Isolated right ventricular myocardial infarction is a very uncommon, but important differential diagnosis of anterior ST-elevation myocardial infarction. There exist certain electrocardiographic features favoring its diagnosis, although, recognition requires a high index of suspicion and support in different modalities of study including cardiac magnetic resonance and coronary angiography. Proper identification of it, will help to guide treatment and support for possible complications.>.
| S-EPMC9214804 | biostudies-literature
Project description:BackgroundTakotsubo cardiomyopathy (TTC) is a non-ischaemic cardiomyopathy, characterized by transient wall motion abnormalities of the left ventricle. Although biventricular involvements are common with a poor prognosis, isolated right ventricular (RV) involvement of TTC is a rare, and its diagnosis remains challenging.Case presentationWe encountered a case of isolated RV-TTC presenting as acute RV failure, with progression to cardiogenic shock requiring intensive treatment. Conflicting echocardiographic findings of RV asynergy with RV enlargement despite normal left ventricular wall motion and mild tricuspid regurgitation led to the correct diagnosis. Finally, the patient showed complete recovery with normalization of cardiac structure and function.ConclusionsThis case underscores the clinical significance of considering isolated RV-TTC as a new distinct variant form of TTC in terms of presentation, diagnostic findings, differential diagnosis, treatment strategy, and prognosis.
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Project description: Not available
| S-EPMC3783140 | biostudies-literature
Project description:Isolated right ventricular myocardial infarctions (MIs) are rare, especially those presenting with anterior ST-segment elevation, which is normally seen in anterior MI. This occurs if the right coronary artery is nondominant. Differentiating between them is important for clinical management. Our case demonstrates a right ventricular MI presenting as an anterior ST-segment elevation myocardial infarction. (Level of Difficulty: Intermediate).
| S-EPMC9091515 | biostudies-literature
Project description: Not available
| S-EPMC10354412 | biostudies-literature
Project description:We described two patients who were successfully resuscitated from out-of-hospital cardiac arrest. Their ECGs showed ST elevations in V1 and aVR, as well as diffuse ST depression. Their ST elevation in V1 was noted to be greater than in aVR. While one patient was found to have an occlusion of the right ventricular (RV) branch of the right coronary artery, the other was found to have an occlusion of a proximal non-dominant right coronary artery supplying the RV branch. Successful primary percutaneous coronary intervention was performed for each patient with angioplasty and implantation of a drug-eluting stent. Both patients made good physical and neurological recovery.
| S-EPMC6441681 | biostudies-literature
Project description:A 79-year-old woman was admitted with a left femoral neck fracture and she immediately developed circulatory shock. Echocardiography showed a markedly enlarged right ventricle (RV) with systolic ballooning of the mid-ventricular wall and preserved contractility of the apex. The left ventricular (LV) motion was normal. Multi-detector-row computed tomography showed severe congestion of the contrast media in the right atrium with no forward flow to RV, but no pulmonary embolism. She was successfully treated with percutaneous veno-arterial extracorporeal membrane oxygenation. This case presented with acute, profound, but reversible RV dysfunction triggered by acute stress in a manner similar to that seen in LV stress cardiomyopathy.
| S-EPMC5596277 | biostudies-literature