Clinical and Electrocardiographic Profile of Inferior Wall Myocardial Infarction with Right Ventricular Involvement: One Year Hospital Based Cross Sectional Study

Background: Myocardial infarction (MI) is being recognised as a major non communicable public health problem across the globe. The unique hemodynamic nature of inferior wall MI with Right Ventricle (RV) involvement, highlighted, the need for its clinical diagnosis as the management protocols of Righ...

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Bibliographic Details
Published inJournal of Krishna Institute of Medical Sciences University Vol. 10; no. 3; pp. 62 - 73
Main Authors Sreedhar Cherulil, Arif Maldar, Romana Khursheed
Format Journal Article
LanguageEnglish
Published Krishna Institute of Medical Sciences University 01.07.2021
Subjects
arrythmia
chest pain
electrocardiogram
inferior wall myocardial infarction
right ventricle dysfunction
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Summary:Background: Myocardial infarction (MI) is being recognised as a major non communicable public health problem across the globe. The unique hemodynamic nature of inferior wall MI with Right Ventricle (RV) involvement, highlighted, the need for its clinical diagnosis as the management protocols of Right Ventricle Myocardial Infraction (RVMI) differ in clinical setup. Aim and Objectives: To characterize, the clinical and Electrocardiogram (ECG) features of patients who present with ECG findings suggestive of Inferior Wall Myocardial Infarction (IWMI) with right ventricular involvement. Material and Methods: The one-year cross sectional study enrolled 40 patients with ECG findings suggestive of right ventricular IWMI and clinical presentation. The categorical data was expressed in terms of rates, ratio and percentage and the continuous data was expressed in terms of mean ± standard deviation. The association between the outcome, clinical and demographic characteristics were analysed by statistical tools. Results: Hypotension and raised Jugular Venous Pressure (JVP) were the most commonly observed clinical findings. In the 12 lead ECG recordings, the concomitant presence of ST elevation in lead V1 and ST depression in lead V2 were found to be correlating statistically with the presence of RV dysfunction. The presence of ST elevation in lead V4R was found to be the most consistent finding on the right sided ECG leads. Neutrophil lymphocyte ratio and arrhythmias were positively associated with mortality in right ventricular IWMI. Conclusion: The right ventricular IWMI presented most commonly with chest pain and raised JVP. The patterns of ECG changes observed were significant for the diagnosis of right ventricular IWMI.
ISSN:2231-4261