Association of the right ventricle impairment with electrocardiographic localization and related artery in patients with ST-elevation myocardial infarction

Authors

KAŇOVSKÝ Jan KALA Petr NOVOTNÝ Tomáš BENEŠOVÁ Klára HOLICKÁ Mária JARKOVSKÝ Jiří KOC Lumír MIKOLÁŠKOVÁ Monika ONDRÚŠ Tomáš MALIK Marek

Year of publication 2016
Type Article in Periodical
Magazine / Source Journal of Electrocardiology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.jelectrocard.2016.08.001
Field Cardiovascular diseases incl. cardiosurgery
Keywords Infarction related artery; Primary percutaneous coronary intervention; Right ventricle infarction; ST elevation myocardial infarction
Description Introduction: The right ventricular myocardial infarction (RVMI) has traditionally been mainly related to inferior wall ST elevation myocardial infarction (STEMI). This study assessed the RVMI electrocardiographic (ECG-RVMI) signs in relationship to ECG-based STEMI localization and to the infarct related artery in patients treated with primary percutaneous coronary intervention (pPCI). Methods: Three hundred consecutive adult patients (107 females) were referred to catheterization laboratory with the acute STEMI diagnosis. In all patients, both the standard 12-lead ECGs and the right-sided precordial leads (V1R-V6R) were recorded. ECG-RVMI was diagnosed by ST segment elevation above 100 mu V in V4R. Results: ECG signs of RVMI were found in 35 and 31 (23.8% for both) patients with inferior and anterior wall STEMI, respectively. In 32 ECG-RVMI patients, the right coronary artery (RCA) was occluded while in 34 patients, the occlusions were in the left anterior descending (LAD) or the left circumflex artery. No statistically significant differences were found in ECG-RVMI patients when comparing clinical variables between those with anterior and inferior wall STEMI. Conclusions: ECG signs of RVMI during acute STEMI are not uncommon. RCA was the infarction related artery in only one half of these patients. Anterior wall STEMI and the LAD were associated with a significant proportion of ECG-RVMI cases.

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