[Infarction of the right ventricle]

Area of Science:

• Cardiology
• Pathophysiology
• Diagnostic Imaging

Background:

• Isolated right ventricular (RV) and anterior biventricular infarcts are uncommon.
• RV extension occurs in 36-50% of postero-inferior infarcts, correlating with acute RV dysfunction.
• Experimental RV infarction is challenging due to RV's ischemic protection.

Purpose of the Study:

• To investigate the incidence and diagnostic methods for right ventricular infarction.
• To understand the pathophysiological mechanisms and hemodynamic consequences of RV infarction.
• To establish treatment strategies based on RV infarction pathophysiology.

Main Methods:

• Review of anatomical studies and clinical findings.
• Analysis of invasive and non-invasive investigation data.
• Correlation of ECG findings (ST-T depression in V3R-V4R-V5R) with clinical presentation (RV infarction syndrome).

Main Results:

• RV infarction often involves proximal right coronary artery thrombosis and significant stenosis.
• Major hemodynamic consequences include adiastole and reduced cardiac output due to impaired LV filling and atrial systole dysfunction.
• Clinical examination and surface ECG can suggest RV infarction, with further investigations confirming systolic dysfunction.

Conclusions:

• Right ventricular infarction diagnosis is feasible and suggested by clinical and ECG findings.
• Understanding RV infarction's pathophysiology is crucial for guiding treatment decisions.
• Coronary angiography is indicated due to the frequent association with coronary artery disease.