Isolated right ventricular myocardial infarction: a case report.

Area of Science:

• Cardiology
• Diagnostic Imaging

Background:

• Isolated right ventricular myocardial infarction (RVMI) from recessive right coronary artery (RCA) occlusion is uncommon.
• It is often associated with complications during percutaneous coronary intervention (PCI).

Purpose of the Study:

• To report a rare case of isolated RVMI due to flush RCA occlusion.
• To highlight the diagnostic challenges and the role of multi-modality imaging.

Main Methods:

• A 61-year-old female presented with symptoms of myocardial infarction.
• Diagnostic workup included transradial coronary angiography, computed tomography pulmonary angiography, cardiac gated computed tomography, and cardiac magnetic resonance imaging.
• The patient was managed conservatively after stabilization from cardiogenic shock.

Main Results:

• Coronary angiography showed no obstructive disease in the left coronary system but failed to selectively cannulate the RCA.
• Cardiac imaging revealed a recessive RCA with an ostial occlusive lesion and confirmed RV free wall infarction.
• The patient stabilized with dobutamine and was discharged after 5 days.

Conclusions:

• This case underscores the rarity of isolated RVMI due to RCA occlusion.
• Multi-modality imaging is essential for accurate diagnosis of such presentations, which can mimic other conditions.