Right ventricular myocardial infarction risk factors: Difference between revisions
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Created page with "{{Right ventricular myocardial infarction}} {{CMG}} ==Overview== ==Risk Stratification== * The presence of [[Right ventricular myocardial infarction|right ventricular infarc..." |
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==Overview== | ==Overview== | ||
==Risk | ==Risk Factors== | ||
* The presence of [[Right ventricular myocardial infarction|right ventricular infarction]] adversely affects the early prognosis. One study, for example, evaluated 200 consecutive patients with acute inferior myocardial infarction | * The presence of [[Right ventricular myocardial infarction|right ventricular infarction]] adversely affects the early prognosis. One study, for example, evaluated 200 consecutive patients with acute inferior myocardial infarction. <ref>Zehender, M, Kasper, W, Kauder, E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 328:981. PMID 8450875</ref> Those with ST elevation in V4R had an almost eight-fold increase in in-hospital mortality (31 versus 6 percent) and morbidity when compared to those without changes in V4R. | ||
* Elderly patients who have right ventricular involvement with an [[Acute myocardial infarction|inferior wall myocardial infarction]] are at particularly high risk. In a study of 198 patients | * Elderly patients who have right ventricular involvement with an [[Acute myocardial infarction|inferior wall myocardial infarction]] are at a particularly high risk. In a study of 198 patients ≥ 75 years of age, right ventricular involvement was associated with an in-hospital mortality of 47 percent compared to a 10 percent mortality in the absence of right ventricular involvement. <ref>Bueno, H, Lopez-Palop, R, Bermejo, J, et al. In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement. Circulation 1997; 96:436. PMID 9788824</ref> | ||
* For patients who survive an acute [[Right ventricular myocardial infarction|right ventricular infarction]] | * For patients who survive an acute [[Right ventricular myocardial infarction|right ventricular infarction]], the prognosis is generally good. As an example, among 522 patients with an [[Acute myocardial infarction|inferior wall infarction]] who were treated with a thrombolytic agent and [[hirudin]] or [[heparin]] in the HIT-4 study, 32 percent had right ventricular involvement and these patients had a higher 30 day mortality when compared to those without right ventricular involvement (5.9 versus 2.5 percent). <ref>Zeymer, U, Neuhaus, K-L, Wegscheider, K, et al. Effects of thrombolytic therapy in acute inferior myocardial infarction with and without right ventricular involvement. J Am Coll Cardiol 1998; 32:876. PMID 9768705</ref> However, this was related to a larger infarct size rather than right ventricular involvement; right ventricular involvement was not an independent predictor of survival. | ||
* The right ventricle frequently recovers the majority of its function, probably due at least in part to decreased oxygen demand of the thin-walled right ventricle <ref>Williams, JF. Right ventricular infarction. Clin Cardiol 1990; 13:309. PMID 2189611</ref> <ref>Cohn, JN. Right ventricular infarction revisited. Am J Cardiol 1979; 43:666. PMID 420117</ref> | * The right ventricle frequently recovers the majority of its function, probably due at least in part to decreased oxygen demand of the thin-walled right ventricle. <ref>Williams, JF. Right ventricular infarction. Clin Cardiol 1990; 13:309. PMID 2189611</ref> <ref>Cohn, JN. Right ventricular infarction revisited. Am J Cardiol 1979; 43:666. PMID 420117</ref> These patients may, however, have a more frequent requirement for a permanent [[pacemaker]]. <ref>Zehender, M, Kasper, W, Kauder, E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 328:981. PMID 8450875</ref> | ||
==References== | ==References== | ||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Intensive care medicine]] | |||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 15:00, 20 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Risk Factors
- The presence of right ventricular infarction adversely affects the early prognosis. One study, for example, evaluated 200 consecutive patients with acute inferior myocardial infarction. [1] Those with ST elevation in V4R had an almost eight-fold increase in in-hospital mortality (31 versus 6 percent) and morbidity when compared to those without changes in V4R.
- Elderly patients who have right ventricular involvement with an inferior wall myocardial infarction are at a particularly high risk. In a study of 198 patients ≥ 75 years of age, right ventricular involvement was associated with an in-hospital mortality of 47 percent compared to a 10 percent mortality in the absence of right ventricular involvement. [2]
- For patients who survive an acute right ventricular infarction, the prognosis is generally good. As an example, among 522 patients with an inferior wall infarction who were treated with a thrombolytic agent and hirudin or heparin in the HIT-4 study, 32 percent had right ventricular involvement and these patients had a higher 30 day mortality when compared to those without right ventricular involvement (5.9 versus 2.5 percent). [3] However, this was related to a larger infarct size rather than right ventricular involvement; right ventricular involvement was not an independent predictor of survival.
- The right ventricle frequently recovers the majority of its function, probably due at least in part to decreased oxygen demand of the thin-walled right ventricle. [4] [5] These patients may, however, have a more frequent requirement for a permanent pacemaker. [6]
References
- ↑ Zehender, M, Kasper, W, Kauder, E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 328:981. PMID 8450875
- ↑ Bueno, H, Lopez-Palop, R, Bermejo, J, et al. In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement. Circulation 1997; 96:436. PMID 9788824
- ↑ Zeymer, U, Neuhaus, K-L, Wegscheider, K, et al. Effects of thrombolytic therapy in acute inferior myocardial infarction with and without right ventricular involvement. J Am Coll Cardiol 1998; 32:876. PMID 9768705
- ↑ Williams, JF. Right ventricular infarction. Clin Cardiol 1990; 13:309. PMID 2189611
- ↑ Cohn, JN. Right ventricular infarction revisited. Am J Cardiol 1979; 43:666. PMID 420117
- ↑ Zehender, M, Kasper, W, Kauder, E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 328:981. PMID 8450875