Detection of acute right ventricular infarction by right precordial electrocardiography

Details

Serval ID
serval:BIB_F46F4A93AA5E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Detection of acute right ventricular infarction by right precordial electrocardiography
Journal
American Journal of Cardiology
Author(s)
Croft  C. H., Nicod  P., Corbett  J. R., Lewis  S. E., Huxley  R., Mukharji  J., Willerson  J. T., Rude  R. E.
ISSN
0002-9149 (Print)
Publication state
Published
Issued date
09/1982
Volume
50
Number
3
Pages
421-427
Notes
Comparative Study Journal Article
Abstract
The value of 0.1 mV or greater of S-T segment elevation in at least one right precordial lead (V4R to V6R) in defining right ventricular myocardial infarction was assessed prospectively in 43 subjects (33 consecutive patients with enzymatically confirmed infarction of varying type and location, 4 patients with unstable angina and 6 healthy volunteers). Patients with acute myocardial infarction were studied with radionuclide ventriculography and technetium-99m stannous pyrophosphate myocardial scintigraphy 18.2 +/- 14.3 (mean +/- standard deviation) and 85.1 +/- 18.0 hours after the onset of symptoms, respectively. Eleven patients (Group A: 9 patients with transmural inferior infarction, 1 with transmural inferolateral infarction and 1 with transmural anteroseptal infarction) demonstrated right precordial S-T segment elevation and 22 patients (Group B: 6 patients with transmural inferior infarction, 2 with transmural posterior infarction, 3 with transmural inferolateral infarction, 3 with transmural anteroseptal infarction, 3 with transmural extensive anterior infarction, 4 with subendocardial anterior infarction and 1 with unclassified infarction) did not. Right ventricular ejection fraction was significantly lower in Group A (0.47 +/- 0.11) than in Group B (0.60 +/- 0.12) (p less than 0.01). Right ventricular total wall motion score was 63.8 +/- 15.6 percent of normal in Group A versus 94.3 +/- 8.5 percent in Group B (p less than 0.001). Technetium-99m pyrophosphate uptake (2+ or greater) over the right ventricle occurred in nine patients (81.8 percent) in Group A and in one patient (4.5 percent) in Group B (p less than 0.001). No patient with unstable angina and no healthy volunteer had S-T segment elevation in a right precordial lead. S-T segment elevation of 0.1 mV or greater in one or more of leads V4R to V6R is both highly sensitive (90 percent) and specific (91 percent) in identifying acute right ventricular infarction.
Keywords
Aged Angina Pectoris, Variant/diagnosis/physiopathology/radionuclide imaging *Electrocardiography Heart Ventricles/physiopathology/radionuclide imaging Humans Male Middle Aged Myocardial Infarction/*diagnosis/physiopathology/radionuclide imaging Prospective Studies Stroke Volume Technetium/diagnostic use *Technetium Tc 99m Pyrophosphate Tin Polyphosphates/diagnostic use
Pubmed
Web of science
Create date
25/01/2008 14:00
Last modification date
20/08/2019 16:21
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