Myocardial infarction. Right ventricular involvement

Abstract

When faced with a lower wall infarction, it is a priority for the emergency physician to suspect its extension to the right ventricle (RV), which occurs in some cases from 10 to 50% of the series, also because its management differs from that established for left ventricular infarction (LVI), and because its possible complications, although rare (10 to 15%), can put the patient's life at risk. They almost always occur as a result of proximal obstruction of the right coronary artery, leading to systolic and diastolic dysfunction of the RV. The stroke volume decreases and the diastolic volume and RV filling increase, causing hypotension and peripheral congestion. Pulmonary blood flow and venous return to the left ventricle are decreased, which can lead to cardiogenic shock. In addition to complications with atrioventricular block. Patients with right ventricular infarction associated with inferior infarcts have a significantly higher frequency of hypotension, bradycardia requiring pacemakers, and higher hospital mortality than infarcts associated with the inferior wall.