Sandbox:Mitra3

All patients with acute inferior wall myocardial infarction (ST elevation in leads II, III, aVF)

Obtain right-sided precordial leads

>= 1mm ST elevation in lead V4R

Highly suggestive of RVMI

Physical examination

Echocardiography

Coronary Angiography

Hemodynamic study

❑ Classic triad of: • Hypotension • Elevated JVP • Clear Lungs ❑ Kussmaul sign ❑ Pulsus paradoxus ❑ Tricuspid regurgitation murmur ❑ Atrioventrcicular dissociation ❑ Vagal symptoms: • Bradycardia • Nausea • Vomiting • Diaphoresis • Pallor

Echocardiography

Coronary Angiography

Hemodynamic study