Incidence, Risk Factors, and Clinical Profile of Right Wall Myocardial Infarction with Inferior Wall Myocardial Infarction at a Single Tertiary Care Centre

Abstract

INTRODUCTION: Right ventricular myocardial infarction can lead to diminished right sided stroke volume with concomitant right ventricular dilatation and septal changes. The potential hemodynamic derangement associated with right ventricular infarction renders the patients unusually sensitive to diminished ventricular preload. These two circumstances can result in a severe decrease in right and, secondarily, left ventricular output resulting in a clinical triad of hypotension and jugular venous pressure distension in the presence of clear lung fields. AIMS & OBJECTIVES: To study the incidence of RVMI in IWMI, risk factors and clinical profile of IWMI. MATERIAL & METHODS: A total of 100 patients were taken. At the time of admission, a 16 lead ECG consisting of twelve conventional leads; and additional right precordial leads V3R, V4R, V5R, V6R were taken, risk factors and clinical features were noted. RESULTS: Maximum number of patients in our study were in the age group 51 to 60 years (35%). IWMI was more common in males. Chest pain was most common symptom in RVMI. Hypertension was present in 40% and diabetes in 24% patients. Smoking was common risk factor in both RVI and NRVI IWMI patients. Hypotension and kussmaul’s sign was present in about 28.5% and 10.7% patients of RVMI. CONCLUSION: Right ventricular involvement in IWMI make the hemodynamics in these patients unstable. This explains the importance of diagnosing RVI in these patients. Keywords: Right Ventricular Infarction (RVI), Non Right Ventricular Infarction (NRVI), Right Precordial Leads (RPL)