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 language | English (US) |
|---|---|
| Title of host publication | Cardiovascular Hemodynamics for the Clinician |
| Subtitle of host publication | Second Edition |
| Publisher | wiley |
| Pages | 299-309 |
| Number of pages | 11 |
| ISBN (Electronic) | 9781119066491 |
| ISBN (Print) | 9781119066477 |
| DOIs | |
| State | Published - Oct 4 2016 |
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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
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 proceeding › Chapter
}
TY - CHAP
T1 - Right ventricular myocardial infarction
AU - Kelly, Robert V.
AU - Cohen, Mauricio G
AU - Stouffer, George A.
PY - 2016/10/4
Y1 - 2016/10/4
N2 - 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.
AB - 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.
KW - Advanced atrioventricular block
KW - Cardiac catheterization
KW - Cardiac output
KW - Echocardiogram
KW - Intrapericardial pressure
KW - Right ventricular dysfunction
KW - Right ventricular myocardial infarction
KW - Systolic hypotension
UR - http://www.scopus.com/inward/record.url?scp=85019482773&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019482773&partnerID=8YFLogxK
U2 - 10.1002/9781119066491.ch25
DO - 10.1002/9781119066491.ch25
M3 - Chapter
AN - SCOPUS:85019482773
SN - 9781119066477
SP - 299
EP - 309
BT - Cardiovascular Hemodynamics for the Clinician
PB - wiley
ER -