In hospital complications and mortality of patients of inferior wall myocardial infarction with right ventricular infarction.

ABSTRACT

This is a cross-sectional study of patients with inferior wall Myocardial Infarction (MI), who attended emergency and got admitted in ICU/CCU of TU Teaching Hospital, Maharajgunj and Bir Hospital, Kathmandu, Nepal during November 1999 to October 2000. This study was undertaken to compare the in-hospital complications and mortality of patients of inferior wall myocardial infarction with or without associated right ventricular infarction. Total 53 consecutive patients with acute inferior wall myocardial infarction were enrolled in the study. Right ventricular infarction was determined by the presence of ST elevation of more than 0.1 mv in V4R. All the patients of inferior wall myocardial infarction were divided into two groups. Group A consisted of patients of inferior wall MI with right ventricular infarction and group B consisted of patients of inferior wall MI without right ventricular infarction. In-hospital complications and mortality of group A were compared with group B. Among 20 patients of group A and 33 patients of group B, incidence of cardiogenic shock was significantly higher in patients of group A compared to group B (p=0.05). Ten patients of group A developed third degree AV Block compared to only one in group B; the incidence of which was significantly higher (p<0.001). Sinus nodal dysfunction, manifested by junctional rhythm was found in six patients of group A compared to only two patients of group B (p<0.05). Mortality was found higher in patients of group A, but it was not statistically significant. Two patients of group A expired on first day whereas only one patient of group B expired on the eighth day of admission. In hospital complications especially cardiogenic shock, complete A-V block and junctional rhythm are significantly higher in inferior wall MI when associated with RV infarction.