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Pure right ventricular infarction resulting from coronary ectasia: importance of diagnostic imaging

Julia A Palfy1, Marta Tomás2, Jerónimo Farré1

  • 1Department of Cardiology, Hospital Universitario Fundación Jiménez Díaz, IDCsalud, Universidad Autónoma de Madrid, Madrid, Spain.

The Canadian Journal of Cardiology
|April 1, 2014
PubMed

Insights

A rare case of isolated right ventricular infarction, not caused by medical procedures, initially mimicked a heart attack from a different artery. Advanced imaging confirmed a blockage in a right coronary artery branch.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Isolated right ventricular (RV) infarction is typically associated with percutaneous coronary intervention (PCI) due to selective occlusion of a right coronary artery (RCA) branch.
  • Differentiating RV infarction from other myocardial infarction types is crucial for appropriate management.

Observation:

  • A case of pure RV infarction without iatrogenic origin is presented.
  • Initial electrocardiographic (ECG) analysis suggested acute myocardial infarction related to the left anterior descending artery.
  • Coronary angiography indicated thrombotic occlusion in a small branch of an ectatic RCA with slow flow.

Findings:

  • Coronary computed tomographic angiography (CCTA) and cardiac magnetic resonance imaging (CMR) confirmed the diagnosis of isolated RV infarction.
  • The findings highlight a non-iatrogenic cause of isolated RV infarction.

Implications:

  • This case underscores the importance of considering non-iatrogenic causes for isolated RV infarction.
  • Advanced imaging modalities like CCTA and CMR play a critical role in the definitive diagnosis of complex coronary artery disease and myocardial infarction.
  • Accurate diagnosis is essential for guiding therapeutic strategies and improving patient outcomes.

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