Skip to main content

Acute Right Ventricular Infarction: Pathogenesis of Low Systemic Output and Therapeutic Implications

  • Conference paper
  • 75 Accesses

Abstract

Right ventricular necrosis frequently accompanies left ventricular infarction. Isolated right ventricular infarction is rare, only observed in approximately 3% of hearts in autopsy studies [1]. Clinically, inferoposterior myocardial infarction is the most frequent association; but in patients who succumb due to cardiogenic shock, left ventricular anterior wall myocardial infarction occurs with higher frequency. Although right ventricular infarction is relatively common, a severe low-output state with or without clinical features of cardiogenic shock occurs only in about 10% of patients. In this brief review, the diagnosis, pathogenesis, and pharmacologic management of low-output state will be described.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Isner J, Roberts WC (1978) Right ventricular infarction complicating left ventricular infarction secondary to coronary heart disease. Am J Cardiol 42: 885–894

    Article  PubMed  CAS  Google Scholar 

  2. Cohn JN, Guiha NH, Broder MI et al. (1974) Right ventricular infarction. Am J Cardiol 33: 209–214

    Article  PubMed  CAS  Google Scholar 

  3. Dell’Italia LJ, Starling MR, O’Rourke RA (1983) Physical examination for exclusion of hemodynamically important right ventricular infarction. Ann Intern Med 99: 608–611

    PubMed  Google Scholar 

  4. Lopez-Sendon J, Coma-Cannella I, Alcasena S et al. (1985) Electrocardiographic findings in acute right ventricular infarction: sensitivity and specificity of electrocardiographic alterations in right precordial leads V4R, V3R, VI, V2 and V3. J Am Coll Cardiol 6: 1273–1979

    Article  PubMed  CAS  Google Scholar 

  5. Sharpe DN, Botvinick EH, Shames DM et al. (1978) The noninvasive diagnosis of right ventricular infarction. Circulation 57: 483–490

    Article  PubMed  CAS  Google Scholar 

  6. Rigo P, Murray M, Taylor DR (1978) Right ventricular dysfunction detected by gated scintiphotography in patients with acute inferior myocardial infarction. Circulation 52: 268–274

    Article  Google Scholar 

  7. Dell’Italia LJ, Starling MMR, Crawford MH et al. (1984) Right ventricular infarction: identification by hemodynamic measurements before and after volume loading and correlation with noninvasive techniques. J Am Coll Cardiol 4: 931–939

    Article  PubMed  Google Scholar 

  8. Lorell B, Leinbach RC, Pohost GM et al. (1979) Right ventricular infarction. Clinical diagnosis and differentiation from cardiac tamponade and pericardial constriction. Am J Cardiol 43: 465–471

    Google Scholar 

  9. Topol EJ, Goldschlager N, Ports TA, DiCarlo LA Jr, Schiller NB, Botvinick EH, Chatterjee K Hemodynamic benefit of atrial pacing in right ventricular myocardial infarction. Ann Intern Med 96: 594–597

    Google Scholar 

  10. Goldstein JA, Vlahakes GJ, Verrier ED et al. (1982) The role of right ventricular systolic dysfunction and elevated intrapericardial pressure in the genesis of low output in experimental right ventricular infarction. Circulation 65: 513–522

    Article  PubMed  CAS  Google Scholar 

  11. Goldstein JA, Vlahakes GJ, Verrier ED et al. (1983) Volume loading improves low cardiac output in experimental right ventricular infarction. J Am Coll Cardiol 2: 270–278

    Article  PubMed  CAS  Google Scholar 

  12. Mikell FL, Asinger RW, Hodges M (1983) Functional consequences of interventricular septal involvement in right ventricular infarction: echocardiographic, clinical, and hemodynamic observations. Am Heart J 105: 393–401

    Article  PubMed  CAS  Google Scholar 

  13. Dell’Italia LJ, Starling MR, Blumhardt R et al. (1985) Comparative effects of volume loading, dobutamine and nitroprusside in patients with predominant right ventricular infarction. Annu Rev Med 34: 377–390

    Google Scholar 

  14. Shah PK, Maddahi J, Berman DS et al. (1985) Scintigraphically detected predominant right ventricular dysfunction in acute myocardial infarction: clinical and hemodynamic correlates and implications for therapy and prognosis. J Am Coll Cardiol 6: 1264–1272

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Chatterjee, K. (1991). Acute Right Ventricular Infarction: Pathogenesis of Low Systemic Output and Therapeutic Implications. In: Lewis, B.S., Kimchi, A. (eds) Heart Failure Mechanisms and Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58231-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-58231-8_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63509-0

  • Online ISBN: 978-3-642-58231-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics