Right Ventricular Infarction: Contribution of Echocardiography to Diagnosis and Management

Right ventricular infarction (RVI) is associated with nearly one third of patients who have inferior myocardial infarction (MI). The classic triad of hypotension, clear lung fields, and increased jugular venous pressure in the setting on inferior MI is highly suggestive of RVI. Direct visualization of the RV and left ventricular chambers on two-dimensional echocardiography allows early diagnosis by demonstration of predominant RV asynergy (akinesis plus dyskinesis), RV dilation, and decreased RV ejection fraction. The extent of RV involvement varies widely and correlates with outcome. Serial two-dimensional echocardiography and Doppler are also valuable in short- and long-term management, to detect complications, and to assess outcome.