Right ventricular myocardial infarction: pathophysiology, clinical implications and management

• Published in: Reviews in cardiovascular medicine Vol. 22; no. 4; pp. 1229 - 1240
• Main Authors: Femia, Giuseppe, French, John K, Juergens, Craig, Leung, Dominic, Lo, Sidney
• Format: Journal Article
• Language: English
• Published: Singapore IMR Press 22.12.2021
• Subjects: acute coronary syndrome; Coronary Vessels; Heart Ventricles; Humans; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Myocardial Infarction - therapy; Percutaneous Coronary Intervention - adverse effects; right ventricular myocardial infarction; shock; Shock, Cardiogenic; Shock; Acute coronary syndrome; Right ventricular myocardial infarction
• ISSN: 1530-6550; 2153-8174
• DOI: 10.31083/j.rcm2204131

Right ventricular myocardial infarction (RVMI) and right ventricular (RV) failure are complications from an acute occlusion of a dominant right coronary artery (RCA) or left anterior descending (LAD) artery. Although some patients have good long-term RV recovery, RVMI is associated with high rates of in-hospital morbidity and mortality driven by hemodynamic compromise, cardiogenic shock, and electrical complications. As such, it is important to identify specific clinical signs and symptoms, initiate resuscitation and commence reperfusion therapy with fibrinolytic therapy or percutaneous coronary intervention. This review will discuss RVMI pathophysiology, describe the current diagnostic measures, highlight current therapies, and explore future management options.