Isolated Right Ventricular Myocardial Infarction Presenting With Anterior ST-Segment Elevation
1Department of Cardiology, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
JACC. Case Reports
|May 16, 2022
Summary
Isolated right ventricular myocardial infarctions (MIs) are uncommon, particularly when they mimic anterior ST-segment elevation MIs. This case highlights a rare presentation of right ventricular MI due to a nondominant right coronary artery, emphasizing the need for accurate differentiation in clinical practice.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Diagnostic Imaging
Background:
- Isolated right ventricular myocardial infarction (RVMI) is a rare clinical entity.
- Anterior ST-segment elevation on electrocardiography (ECG) typically indicates an anterior myocardial infarction (MI) affecting the left ventricle.
- RVMI can present atypically, posing diagnostic challenges.
Purpose of the Study:
- To describe a rare case of isolated right ventricular myocardial infarction (RVMI) presenting with anterior ST-segment elevation.
- To emphasize the importance of differentiating RVMI from anterior MI for appropriate clinical management.
- To illustrate a scenario where a nondominant right coronary artery leads to RVMI with an anterior ECG pattern.
Main Methods:
- Case report presentation.
- Review of clinical presentation, electrocardiographic findings, and coronary angiography.
- Discussion of diagnostic criteria and management implications.
Main Results:
- The case demonstrated a right ventricular myocardial infarction (RVMI) with electrocardiographic findings mimicking an anterior ST-segment elevation myocardial infarction (STEMI).
- Coronary angiography revealed a nondominant right coronary artery as the culprit vessel.
- Accurate differentiation was crucial for guiding therapeutic strategies.
Conclusions:
- Isolated right ventricular myocardial infarction (RVMI) can present with anterior ST-segment elevation, a pattern usually associated with anterior MI.
- The anatomical variation of a nondominant right coronary artery is a key factor in this atypical presentation.
- Clinical vigilance and appropriate diagnostic workup are essential for distinguishing RVMI from anterior MI to ensure optimal patient outcomes.
Keywords:
LCx, left circumflex arteryLV, left ventricleMI, myocardial infarctionPDA, posterior descending arteryRCA, right coronary arteryRV, right ventricleSTEMI, ST-segment elevation myocardial infarctionacute coronary syndromeelectrocardiogrammyocardial infarctionright ventriclestentsMore Related Videos
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