THE ELECTROCARDIOGRAPHIC PREVALENCE OF RIGHT VENTRICULAR INFARCTION IN PATIENTS WITH ACUTE INFERIOR ST-ELEVATION MYOCARDIAL INFARCTION

Abstract

BackgroundRight ventricular myocardial infarction (RVMI) is associated with acute inferior STEMI in 30 to 50 % of cases and poor outcome of RVMI is usually related to profound hemodynamic and electrical complications, which occur in approximately 50 % of cases . In contrast, RVMI associated with anterior wall myocardial infarction in less than 10% of cases and isolated RV infarction is rare. It is the posterior RV wall that is most frequently involved in RV infarction and nearly always in association with left ventricular posterior and posteroseptal infarction .So right precordial leads (V4R & V5R) are recommended in patients with acute inferior STEMI, especially in the presence of hypotension and bradycardia. ObjectiveTo identify the prevalence of right ventricular infarction (RVI) in patients with acute inferior myocardial infarction (AIMI) within 24 hours of starting manifestations of infarction who got suitable precordial ECG and to detect associated risk factors that increase the risk of RVI in the setting of inferior MI in Sulaimani city/Kurdistan region/Iraq. MethodsOne hundred patients with acute Inferior STEMI were included in the study. A simplified cardiovascular questionnaire was used, and a detailed physical examination and a standard 12-lead ECG, RPLs, and cardiac enzyme assay were carried out. ResultsRight Ventricular Infarction RVI was present in 39% of cases with acute inferior STEMI. The age group 50-59 years was most commonly affected (57.9%). Females more commonly have RVI than males. There was no significant difference between patients with RVI and non-RVI regarding residence and occupation. Both hypertension HT) and diabetes mellitus (DM) were the most dominant chronic diseases (55 % and 45 %, respectively). ConclusionRight ventricular infarction was found in 39% of patients with acute inferior STEMI. Right precordial leads (V4R & V5R) are recommended in patients with acute inferior STEMI, especially in the presence of hypotension and bradycardia.