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Acute right ventricular myocardial infarction
- Publication Year :
- 2018
-
Abstract
- Acute right ventricular myocardial infarction (RVMI) is observed in 30-50% of patients presenting with inferior wall myocardial infarction (MI) and, occasionally, with anterior wall MI. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps, and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography, and coronary angiography, whereas noninvasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role. Early revascularization, percutaneous or pharmacological, represents key step in the management of RMVI. Maintenance of reasonable heart rate and atrioventricular synchrony is essential to sustain adequate cardiac output in these patients. When conventional treatment is not successful, mechanical circulatory support, including right ventricle assist devices, percutaneous cardiopulmonary support, and intra-aortic balloon pump, might be considered. The prognosis associated with RVMI is worse in the short term, compared to non-RVMI, but those patients who survive hospitalization have a relatively good long-term prognosis.
- Subjects :
- medicine.medical_specialty
Cardiac output
Heart Ventricles
medicine.medical_treatment
Shock, Cardiogenic
Ischemia
610 Medicine & health
030204 cardiovascular system & hematology
Coronary Angiography
Revascularization
2705 Cardiology and Cardiovascular Medicine
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Cardiac magnetic resonance imaging
Internal medicine
Internal Medicine
Humans
Medicine
030212 general & internal medicine
Myocardial infarction
revascularizatio
medicine.diagnostic_test
business.industry
Cardiogenic shock
Hemodynamics
10181 Clinic for Nuclear Medicine
General Medicine
medicine.disease
Magnetic Resonance Imaging
medicine.anatomical_structure
myocardial infarction
Echocardiography
Ventricle
2724 Internal Medicine
Cardiology
Right ventricle
Heart-Assist Devices
prognosis
business
Cardiology and Cardiovascular Medicine
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....aaddc306310fecd419db6618d920e125