[Value of hemodynamic evaluation in infarction of the right ventricle]

Right cardiac catheterisation was the first method of investigation proposed for the diagnosis of right ventricular dysfunction during the acute phase of biventricular myocardial infarction. With the development of non-invasive methods of investigation (radio-isotopes and particularly ultrasonography), the value of haemodynamic surveys has become open to question. This paper aims to demonstrate that this minimally traumatic investigation, which can be performed in any intensive care unit, is still useful: for the diagnosis of infarction of the right ventricle (RV), as, provided it is performed sufficiently early in the course of the disease and possibly associated with a filling test to increase the sensitivity, it provides very specific and very sensitive criteria: disproportionate elevation of the RV filling pressure, morphological syndrome of adiastole; for the diagnosis of associated mechanical complications: tricuspid incompetence, by analysis of the curve of the RA pressure; intraventricular shunt due to septal perforation or a right-to-left shunt during atrial relaxation through an intra-atrial communication or PFO, by means of staged oximetry; for the analysis of the distal effects of the RV dysfunction: RV filling pressure and cardiac output; and finally, by means of haemodynamic monitoring, for the orientation and monitoring of treatment in the severe forms responsible for a low output state.