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

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)

Fingerprint Dive into the research topics of 'Right ventricular myocardial infarction'. Together they form a unique fingerprint.

  • 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