A study of clinical manifestations of right ventricular myocardial infarction

Introduction: Myocardial Infarction is the term used when the myocardium is necrosed due to ischemia. It may be trans mural or subendocardial. Inferior wall infarction has got some special features like the association with Right ventricular infarction and Brady arrhythmias especially sinus bradycardia and heart blocks. Clinically Right Ventricular Myocardial Infarction can be suspected when a patient with Inferior Wall Myocardial Infarction presents with elevated JVP, positive Kussmaul's sign, hypotension, right-sided third or fourth heart sounds, tender hepatomegaly, and oliguria rarely TR and clear chest. Aim of the study: To study the various clinical manifestation of Right Ventricular Myocardial Infarction. To study the Clinical profile, Risk factors, ECG features, Complications and Outcome of Right Ventricular Myocardial Infarction. Materials and methods: This study was mainly conducted to find out the clinical manifestations of right ventricular myocardial infarction and its risk factors, ECG features, complications and outcome of RVMI. All patients admitted to Intensive Coronary Care Unit with ST elevation in V4R were taken for study. Presence of an aneurysm, mitral regurgitation, left ventricular clot or pericardial effusion was noted. Ejection fraction was determined by-Mode and2-D using Simpson's rule. Results: During the study period 474 cases of acute myocardial infarction were admitted and. Out of 474 cases, 242 were acute inferior wall myocardial infarction. 106 cases showed evidence of right ventricular myocardial infarction in ECG. All the 106 cases were associated with inferior wall myocardial infarction. Angina was present in 73% of patient. Angina was equivalent to 27%. All patients with chest pain were associated with sweating. Nausea, vomiting, and Indigestion were the common presenting angina equivalents in young. Dyspnea was the predominant symptom in elderly people. Most of the patients with angina equivalents were Diabetes. Conclusion: All cases of Inferior Wall Myocardial Infarction should have Right sided chest leads recorded during ECG examination as more the ST elevation more the severity of Right Ventricular Myocardial Infarction and its complications and mortality rate. If the diagnosis of Right Ventricular Myocardial Infarction is correctly made earlier and thrombolysed the prognosis is usually good even in patients with complications.