RV involved in AMI more often than you think

January 24, 2011 by  
Filed under Acute Med, All Updates, Resus

We know that inferior STEMI may be complicated by right ventricular involvement, which is why I whack a V4R lead on all my inferior AMI patients. A recent study using cardiac magnetic resonance imaging showed that RV oedema and regional or global RV dysfunction were common in anterior infarcts too, although the proportion significantly decreased at four month follow up.

T2w image of patient with LAD occlusion. Hyperintense appearance of jeopardised anteroseptal and anterior LV myocardium (arrowheads), extending to adjacent RV lateral free wall (arrows)

RV abnormalities are contiguous to the jeopardized LV myocardium and do not occur exclusively in inferior LV infarcts, but are found in up to 33% of anterior LV infarcts as well. The presence of RV ischemic injury is associated with early RV dysfunction as well as with RV functional recovery at follow-up.

Right Ventricular Ischemic Injury in Patients With Acute ST-Segment Elevation Myocardial Infarction: Characterization With Cardiovascular Magnetic Resonance.
Circulation. 2010 Oct 5;122(14):1405-12

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One Response to “RV involved in AMI more often than you think”

  1. Tweets that mention RV involved in AMI more often than you think | Resus M.E! -- Topsy.com on January 25th, 2011 00:49

    [...] This post was mentioned on Twitter by precordialthump, Cliff Reid. Cliff Reid said: Not just in inferior AMI……right ventricle dysfunction is common in anterior infarcts too. http://tinyurl.com/rv-surprise [...]