Author + information
- Received August 23, 1982
- Revision received January 12, 1983
- Accepted January 14, 1983
- Published online June 1, 1983.
- Ronald S. Baigrie, MD, FACC*,
- Aminul Haq, MD*,
- Christopher D. Morgan, MD,
- Harry Rakowski, MD,
- Milutin Drobac, MD and
- Peter McLaughlin, MD, FACC
- ↵*Address for reprints: Ronald S. Baigrie, MD, Sunnybrook Medical Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
The clinical experience with 37 patients with acute transmural inferior wall myocardial infarction who were assessed for evidence of right ventricular involvement is reported. On the basis of currently accepted hemodynamic criteria, 29 patients (78%) had evidence suggestive of right ventricular infarction. However, only 5 (20%) of 25 patients demonstrated right ventricular uptake of technetium pyrophosphate on scintigraphy. Two-dimensional echocardiography or isotope nuclear angiography, or both, were performed in 32 patients; 20 studies (62%) showed evidence of right ventricular wall motion disturbance or dilation, or both.
Twenty-one patients demonstrated a late inspiratory increase in the jugular venous pressure (Kussmaul's sign). The presence of this sign in the clinical setting of inferior wall myocardial infarction was predictive for right ventricular involvement in 81 % of the patients in this study. It is suggested that right ventricular involvement in this clinical setting is common and includes not only infarction but also dysfunction without detectable infarction, which is likely on an ischemic basis.
- Received August 23, 1982.
- Revision received January 12, 1983.
- Accepted January 14, 1983.
- American College of Cardiology Foundation