[Right heart failure after infarction of the right ventricle (author's transl)]

The right ventricular filling pressure was raised above 10 mm Hg in 20 cases (12%) out of 175 patients haemodynamically monitored in the acute phase after cardiac infarction. The end-diastolic pulmonary arterial pressure was not above 18 mm Hg so that in these cases an extensive necrosis of the right ventricle must be assumed to be the cause of right heart failure. In 75% of these patients with predominantly right sided infarction there was a posterior wall infarct whereas in patients with left heart failure the anterior wall was significantly more often affected. Patients with posterior wall infarction and right heart failure had more commonly infarct signs in the right precordial chest leads Vr3 to Vr6 and an increased diameter of the right ventricle in the echocardiogram than patients with posterior wall infarction but without right heart failure. However, a definite separation of the two groups was not possible with these non-invasive techniques. Haemodynamic changes should thus be decisive for the diagnosis of predominantly right heart infarction as these dictate the treatment.