Acute right ventricular myocardial infarction

Arif Albulushi, Andreas Giannopoulos, Nikolaos Kafkas, Stylianos Dragasis, Gregory Pavlides, Ioannis S Chatzizisis

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Introduction: Acute right ventricular myocardial infarction (RVMI) is observed in 30–50% of patients presenting with inferior wall myocardial infarction (MI) and, occasionally, with anterior wall MI. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps, and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography, and coronary angiography, whereas noninvasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role. Early revascularization, percutaneous or pharmacological, represents key step in the management of RMVI. Maintenance of reasonable heart rate and atrioventricular synchrony is essential to sustain adequate cardiac output in these patients. When conventional treatment is not successful, mechanical circulatory support, including right ventricle assist devices, percutaneous cardiopulmonary support, and intra-aortic balloon pump, might be considered. The prognosis associated with RVMI is worse in the short term, compared to non-RVMI, but those patients who survive hospitalization have a relatively good long-term prognosis.

Original languageEnglish (US)
Pages (from-to)455-464
Number of pages10
JournalExpert review of cardiovascular therapy
Volume16
Issue number7
DOIs
StatePublished - Jul 3 2018

Fingerprint

Myocardial Infarction
Anterior Wall Myocardial Infarction
Inferior Wall Myocardial Infarction
Heart-Assist Devices
Cardiogenic Shock
Coronary Angiography
Cardiac Output
Hypotension
Physical Examination
Heart Ventricles
Echocardiography
Electrocardiography
Hospitalization
Ischemia
Biomarkers
Heart Rate
Hemodynamics
Maintenance
Magnetic Resonance Imaging
Pharmacology

Keywords

  • Right ventricle
  • myocardial infarction
  • prognosis
  • revascularization

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Acute right ventricular myocardial infarction. / Albulushi, Arif; Giannopoulos, Andreas; Kafkas, Nikolaos; Dragasis, Stylianos; Pavlides, Gregory; Chatzizisis, Ioannis S.

In: Expert review of cardiovascular therapy, Vol. 16, No. 7, 03.07.2018, p. 455-464.

Research output: Contribution to journalReview article

Albulushi, Arif ; Giannopoulos, Andreas ; Kafkas, Nikolaos ; Dragasis, Stylianos ; Pavlides, Gregory ; Chatzizisis, Ioannis S. / Acute right ventricular myocardial infarction. In: Expert review of cardiovascular therapy. 2018 ; Vol. 16, No. 7. pp. 455-464.
@article{1f73022b6f9248cf9371691cf046e4ca,
title = "Acute right ventricular myocardial infarction",
abstract = "Introduction: Acute right ventricular myocardial infarction (RVMI) is observed in 30–50{\%} of patients presenting with inferior wall myocardial infarction (MI) and, occasionally, with anterior wall MI. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps, and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography, and coronary angiography, whereas noninvasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role. Early revascularization, percutaneous or pharmacological, represents key step in the management of RMVI. Maintenance of reasonable heart rate and atrioventricular synchrony is essential to sustain adequate cardiac output in these patients. When conventional treatment is not successful, mechanical circulatory support, including right ventricle assist devices, percutaneous cardiopulmonary support, and intra-aortic balloon pump, might be considered. The prognosis associated with RVMI is worse in the short term, compared to non-RVMI, but those patients who survive hospitalization have a relatively good long-term prognosis.",
keywords = "Right ventricle, myocardial infarction, prognosis, revascularization",
author = "Arif Albulushi and Andreas Giannopoulos and Nikolaos Kafkas and Stylianos Dragasis and Gregory Pavlides and Chatzizisis, {Ioannis S}",
year = "2018",
month = "7",
day = "3",
doi = "10.1080/14779072.2018.1489234",
language = "English (US)",
volume = "16",
pages = "455--464",
journal = "Expert Review of Cardiovascular Therapy",
issn = "1477-9072",
publisher = "Expert Reviews Ltd.",
number = "7",

}

TY - JOUR

T1 - Acute right ventricular myocardial infarction

AU - Albulushi, Arif

AU - Giannopoulos, Andreas

AU - Kafkas, Nikolaos

AU - Dragasis, Stylianos

AU - Pavlides, Gregory

AU - Chatzizisis, Ioannis S

PY - 2018/7/3

Y1 - 2018/7/3

N2 - Introduction: Acute right ventricular myocardial infarction (RVMI) is observed in 30–50% of patients presenting with inferior wall myocardial infarction (MI) and, occasionally, with anterior wall MI. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps, and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography, and coronary angiography, whereas noninvasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role. Early revascularization, percutaneous or pharmacological, represents key step in the management of RMVI. Maintenance of reasonable heart rate and atrioventricular synchrony is essential to sustain adequate cardiac output in these patients. When conventional treatment is not successful, mechanical circulatory support, including right ventricle assist devices, percutaneous cardiopulmonary support, and intra-aortic balloon pump, might be considered. The prognosis associated with RVMI is worse in the short term, compared to non-RVMI, but those patients who survive hospitalization have a relatively good long-term prognosis.

AB - Introduction: Acute right ventricular myocardial infarction (RVMI) is observed in 30–50% of patients presenting with inferior wall myocardial infarction (MI) and, occasionally, with anterior wall MI. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps, and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography, and coronary angiography, whereas noninvasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role. Early revascularization, percutaneous or pharmacological, represents key step in the management of RMVI. Maintenance of reasonable heart rate and atrioventricular synchrony is essential to sustain adequate cardiac output in these patients. When conventional treatment is not successful, mechanical circulatory support, including right ventricle assist devices, percutaneous cardiopulmonary support, and intra-aortic balloon pump, might be considered. The prognosis associated with RVMI is worse in the short term, compared to non-RVMI, but those patients who survive hospitalization have a relatively good long-term prognosis.

KW - Right ventricle

KW - myocardial infarction

KW - prognosis

KW - revascularization

UR - http://www.scopus.com/inward/record.url?scp=85049551962&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049551962&partnerID=8YFLogxK

U2 - 10.1080/14779072.2018.1489234

DO - 10.1080/14779072.2018.1489234

M3 - Review article

C2 - 29902098

AN - SCOPUS:85049551962

VL - 16

SP - 455

EP - 464

JO - Expert Review of Cardiovascular Therapy

JF - Expert Review of Cardiovascular Therapy

SN - 1477-9072

IS - 7

ER -