Right ventricular myocardial infarction diagnostic criteria

Right ventricular myocardial infarction Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

This diagnosis of right ventricular myocardial infarction should be considered in patients with the clinical triad of hypotension, clear lung fields, and jugular venous distention. The diagnosis can be made using a right-sided electrocardiogram, on which ST-segment elevation in leads V3R and V4R is found.

Laboratory Studies

The diagnosis of right ventricular infarction is suspected in the appropriate clinical setting when the right atrial pressure exceeds 10 mmHg and the ratio of right atrial pressure to pulmonary capillary wedge pressure exceeds 0.8 (normal mean value less than 0.6) .

However, these findings may not be present in patients with only minimal right ventricular dysfunction or in those with intravascular volume depletion. In the latter setting, a volume challenge may unmask the signs of right ventricular infarction