Right ventricular infarction

Right ventricular (RV) infarction, once considered rare, is now recognized as common in patients with inferior infarction. It usually involves the posterior wall of the right ventricle and seldom the anterior right ventricle. There is concomitant transmural injury to the posterior wall of the left ventricle and interventricular septum. Severe RV dysfunction may be associated with cardiogenic shock, and conventional treatment may be deleterious. Avoidance of diuretics and administration of fluids is associated with a much better prognosis. Hemodynamic monitoring is necessary and the diagnosis should be confirmed by radionuclide assessment. Exclusion of tamponade and constrictive pericarditis by echocardiography is often essential.