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Percutaneous transluminal coronary angioplasty as a cause of isolated right ventricular infarction
H I Miller1, I Shapira, J Chernilas
1Department of Cardiology, Tel-Aviv Medical Center, Israel.
Insights
Percutaneous transluminal coronary angioplasty (PTCA) can cause myocardial infarction. However, isolated right ventricular infarction from a PTCA-occluded branch is rare and typically has benign long-term effects.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Acute myocardial infarction is a known complication of percutaneous transluminal coronary angioplasty (PTCA).
- Isolated right ventricular infarction is an uncommon clinical presentation.
Observation:
- A 60-year-old patient developed right ventricular branch occlusion post-PTCA for a dominant right coronary artery. Symptoms included chest pain and ECG changes.
- The patient experienced transient creatine kinase elevation and reduced right ventricular ejection fraction (18%).
Findings:
- The patient's clinical course was uneventful following the event.
- Right ventricular ejection fraction improved significantly to 36% within a week.
Implications:
- Occlusion of a right ventricular branch during PTCA is rarely of clinical significance.
- Long-term effects of isolated right ventricular infarction appear to be benign.
Abstract:
Acute myocardial infarction is a recognized major complication of percutaneous transluminal coronary angioplasty (PTCA). Isolated right ventricular infarction is rare. A 60-year-old patient underwent PTCA 24 h following clinically successful thrombolytic therapy for an acute occlusion of a dominant right coronary artery. Following successful PTCA of this artery, a right ventricular branch was noted to be occluded. This was associated with chest pain, elevated venous pressure, S-T segment elevation in ECG leads V1-3, and a transient rise in serum creatine kinase. The clinical course was uneventful and a week later the right ventricular ejection fraction had increased from 18 to 36%. The long-term effects of right ventricular infarction are benign and occlusion of a right ventricular branch during PTCA is rarely of clinical significance.