Subject(s)
Electrocardiography , Heart/physiology , Hyperventilation/physiopathology , Adult , Exercise Test , Female , Humans , MaleABSTRACT
Seventy-three patients were subjected to bicycle ergometry and exercise-induced ST-segment changes in right-sided chest leads were correlated with changes in conventional leads. ST-segment elevation in right-sided chest leads was found to be more frequent than ST-segment depression. ST-segment elevation in right-sided chest leads was commonly reciprocal to ST-segment depression in leads V3 to V7, indicating that this change is usually secondary to left ventricular subendocardial ischemia, rather than to right ventricular ischemia. ST-segment depression in right-sided chest leads was mostly a primary change indicating right ventricular subendocardial or posterior wall ischemia. It is, therefore, felt that ST-segment depression in right-sided chest leads is more sensitive and specific for right ventricular ischemia than ST-segment elevation in these leads.
Subject(s)
Electrocardiography/standards , Electrodes/standards , Exercise Test/standards , Myocardial Ischemia/diagnosis , Ventricular Function, Right , Adult , Diagnosis, Differential , Electrocardiography/instrumentation , Evaluation Studies as Topic , Female , Humans , Male , Myocardial Ischemia/epidemiology , Myocardial Ischemia/physiopathology , Sensitivity and SpecificityABSTRACT
The literature on isolated right ventricular infarction is reviewed and local experience is reported. Chronic lung disease is an important risk factor. Chest pain and breathlessness are common. Syncope and sudden collapse can also occur. Rhythm disorders include sinus bradycardia, atrial fibrillation and ventricular tachycardia or fibrillation. Atrioventricular block is rare. Hypotension and a right-sided fourth heart sound are common. Cautious use of slow-release nitroglycerin is not hazardous in the absence of hypotension. High doses of steroids and anticoagulants can be helpful. The prognosis is usually good, although sudden collapse can occur due to ventricular fibrillation, rupture of the right ventricular free wall or massive pulmonary embolism.
Subject(s)
Heart Ventricles , Myocardial Infarction , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Anticoagulants/therapeutic use , Echocardiography , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/drug therapy , Nitroglycerin/therapeutic use , PrognosisABSTRACT
A case of isolated right ventricular infarction mimicking additional infero-posterior left ventricular infarction on the surface electrocardiogram is presented. Gross dilatation of the right ventricle was probably responsible for the electrocardiographic findings.
Subject(s)
Myocardial Infarction/diagnosis , Diagnosis, Differential , Echocardiography , Electrocardiography , Heart Ventricles/pathology , Humans , Middle AgedABSTRACT
Acute transmural anteroseptal myocardial infarction with acute left ventricular failure can also raise systemic venous pressure in the absence of right ventricular infarction. Right ventricular infarction, therefore, should not be diagnosed simply by the presence of systemic venous congestion.
