Right ventricular myocardial infarction electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The diagnosis can be made using a right-sided electrocardiogram, on which ST-segment elevation in leads V3R and V4R will be seen.
Electrocardiogram
- In addition to evidence of an acute inferior or inferoposterior myocardial infarction, the ECG may demonstrate ≥ 1 mm of doming ST elevation in the right sided precordial leads V4R to V6R.
- Right sided ST elevation, particularly in V4R, is indicative of acute right ventricular injury [1] [2] [3] and correlates closely with occlusion of the proximal right coronary artery.
- In one report of patients with acute inferior infarction, for example, ST elevation in V4R had 88 percent sensitivity and 78 percent specificity for concurrent right ventricular infarction. [4]
- Pulmonary embolism, pericarditis, and anteroseptal myocardial infarction also cause elevation of the ST segment in the right-sided precordial leads. As a result, an electrocardiographic diagnosis of right ventricular infarction cannot be made when one of these conditions is present. [5] [6]
Right Ventricular Myocardial Infarction EKG Examples
References
- ↑ Isner, JM. Right ventricular myocardial infarction. JAMA 1988; 259:712. PMID 3275819
- ↑ Kinch, JW, Ryan, TJ. Right ventricular infarction. N Engl J Med 1994; 330:1211. PMID 8139631
- ↑ 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
- ↑ 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.
- ↑ Williams, JF. Right ventricular infarction. Clin Cardiol 1990; 13:309. PMID 2189611
- ↑ Kahn, JK, Bernstein, M, Bengston, JR. Isolated right ventricular myocardial infarction. Ann Intern Med 1993; 118:708. PMID 8460858