Right ventricular myocardial infarction

Robert V. Kelly, Mauricio G Cohen, George A. Stouffer

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Severe right ventricular (RV) dysfunction leading to the classic hemodynamic changes occurs in approximately 10% of inferior myocardial infarctions and is associated with higher rates of mortality, cardiogenic shock, sustained ventricular arrhythmias, and advanced atrioventricular (AV) block. The RV is pyramidal shaped with a triangular base and a thin crescentic free wall. The diagnosis of RV myocardial infarction is made using the clinical presentation in combination with echocardiogram (ECG), echocardiographic, and/or hemodynamic criteria. Abrupt RV dilatation within a noncompliant pericardium leads to elevated intrapericardial pressure. RV infarction is characterized by increased RA and RV diastolic pressures, low cardiac output, and systolic hypotension. LV dysfunction (e.g., inferior myocardial infarction) increases RV afterload, which can further reduce cardiac output. Management of RV infarction can be summarized as follows: early recognition+reperfusion+volume expansion±dobutamine. Once RV preload is optimized, dobutamine may improve RV function and cardiac output.

Original languageEnglish (US)
Title of host publicationCardiovascular Hemodynamics for the Clinician
Subtitle of host publicationSecond Edition
Publisherwiley
Pages299-309
Number of pages11
ISBN (Electronic)9781119066491
ISBN (Print)9781119066477
DOIs
StatePublished - Oct 4 2016

Fingerprint

Inferior Wall Myocardial Infarction
Cardiac Output
Infarction
Hemodynamics
Myocardial Infarction
Right Ventricular Dysfunction
Low Cardiac Output
Right Ventricular Function
Dobutamine
Cardiogenic Shock
Atrioventricular Block
Pericardium
Ventricular Pressure
Hypotension
Reperfusion
Cardiac Arrhythmias
Dilatation
Blood Pressure
Pressure
Mortality

Keywords

  • Advanced atrioventricular block
  • Cardiac catheterization
  • Cardiac output
  • Echocardiogram
  • Intrapericardial pressure
  • Right ventricular dysfunction
  • Right ventricular myocardial infarction
  • Systolic hypotension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kelly, R. V., Cohen, M. G., & Stouffer, G. A. (2016). Right ventricular myocardial infarction. In Cardiovascular Hemodynamics for the Clinician: Second Edition (pp. 299-309). wiley. https://doi.org/10.1002/9781119066491.ch25

Right ventricular myocardial infarction. / Kelly, Robert V.; Cohen, Mauricio G; Stouffer, George A.

Cardiovascular Hemodynamics for the Clinician: Second Edition. wiley, 2016. p. 299-309.

Research output: Chapter in Book/Report/Conference proceedingChapter

Kelly, RV, Cohen, MG & Stouffer, GA 2016, Right ventricular myocardial infarction. in Cardiovascular Hemodynamics for the Clinician: Second Edition. wiley, pp. 299-309. https://doi.org/10.1002/9781119066491.ch25
Kelly RV, Cohen MG, Stouffer GA. Right ventricular myocardial infarction. In Cardiovascular Hemodynamics for the Clinician: Second Edition. wiley. 2016. p. 299-309 https://doi.org/10.1002/9781119066491.ch25
Kelly, Robert V. ; Cohen, Mauricio G ; Stouffer, George A. / Right ventricular myocardial infarction. Cardiovascular Hemodynamics for the Clinician: Second Edition. wiley, 2016. pp. 299-309
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