Right ventricular infarction: Epidemiological, clinical and angiographic characteristics and the outcomes through the experience of a Moroccan cardiology department

Abstract

Background: Acute myocardial infarction is a major cause of cardiovascular mortality, which is the leading cause of death in the world. Our objective in this study was to evaluate the epidemiological, clinical and angiographic features of right ventricular infarction, as well as its complications and its therapeutic approaches. Patients and methods: It is a single-centered retrospective descriptive study conducted over a period of 2 years from November 2018 to October 2020. We included 82 patients with RVI hospitalized in the cardiovascular intensive care unit during the initial phase of acute coronary syndrome with persistent ST segment elevation. Patients who were diagnosed with RVI at electrocardiogram and echocardiography were recruited. Results: We included 500 patients hospitalized for STEMI, 82 had myocardial infarction extended to the RV, reflecting a rate of 16.4%. The mean age in our study was 64 ± 12.3 years. Dyslipidemia, diabetes mellitus and hypertension were the most common cardiovascular risk factors among these patients. RVI co-existed with inferior myocardial infarction in 62.2% of cases and in 37.8% of anterior myocardial infarction, while isolated right ventricular infarction was seen in only one patient. Transthoracic echocardiography showed right ventricular systolic dysfunction in 24.39% of cases, while right ventricular dilatation was seen in only 10.9% of patients. Therapeutic approach was based essentially on revascularization with thrombolysis and coronary angiography +/- PCI. The percentage of mortality was 2.4%. Conclusion: Right ventricular infarction is relatively rare and is mostly related to an extension of an inferior myocardial infarction. Early diagnosis, prompt treatment and appropriate are the keys to improve prognosis, and reduce complications.