ABSTRACT
To know the frequency of right ventricular infarction in patients with acute inferior wall myocardial infarction. Retrospective study. This study was carried out in Department of Medicine at Civil Hospital Karachi from 1[st] November 2011 to 30[th] April 2012. In this study 65 adult patients of either sex with ECG evidence of inferior wall infarction were enrolled who were admitted in medical department at Civil Hospital Karachi. The duration of the study was 6 months. Inclusion criteria were age > 12 years of either sex or acute inferior wall myocardial infarction on electrocardiography [ST- segment elevation of more than or equal to 1 mm in at least two or three leads i.e. II, III, and aVF]. Exclusions criteria were age less than 12 years and evidence of either right or left bundle branch block on ECG. Data was analyzed through SPSS software. Out of these 65 patients, 45 [69%] were male and 20 [31 %] were female. All patients with acute inferior wall myocardial infarction were divided into three age groups i.e. 3[4%]cases were < 40 years, 44[58.66%] cases between 40-60years , and 18[24%] cases in > 60 years. From a total of 65 patients presented with acute inferior wall myocardial infarction, 40 [62%] were not associated with right ventricular infarction [Group-I], whereas 25 [38%] were associated with right ventricular infarction [Group-II], On ECG, ST-segment elevation in leads V 3R and V 4R was present in 1 out of 40 [2.5%] patients in Group-I, and 23 out of 25 [92%] in Group-II [p=<0.001]. The sensitivity, specificity, positive and negative predictive value of raised JVP was 72%, 82.5%, 78.2% and 82.5% respectively. The sensitivity, specificity, positive and negative predictive value of clear lung fields in the presence of raised JVP was 84%, 87.5%, 80.7% and 89.7% respectively. ST-segment elevation in leads V3R and V4R was 92% sensitive, 97.5% specific, having 95.8% positive and 95.12% negative predictive value. On echocardiography right ventricular dilatation was 96% sensitive, 97.5% specific, having 96% positive and 97.5% negative predictive value. In conclusion, frequency of right ventricular infarction is 38.46% in association with inferior infarction in our clinical settings