Abstract
Isolated right ventricular (RV) infarction may occur during percutaneous coronary
intervention resulting from selective occlusion of a ventricular branch of the right
coronary artery (RCA). We present a case of a pure RV infarction without iatrogenic
origin that at the initial electrocardiographic analysis was suggestive of a left
anterior descending artery–related acute myocardial infarction. Coronary angiography
results made us suspect thrombotic occlusion of a small branch of the ectatic RCA
resulting from slow flow. Final diagnosis was confirmed by coronary computed tomographic
angiography and cardiac magnetic resonance imaging, underlining the essential diagnostic
role of these imaging modalities.
Résumé
L’infarctus isolé du ventricule droit (VD) peut se manifester au cours de l’intervention
coronarienne percutanée résultant d’une occlusion sélective d’une branche ventriculaire
de l’artère coronaire droite (ACD). Nous présentons un cas de véritable infarctus
du VD sans origine iatrogène qui, à l’analyse électrocardiographique, suggérait un
infarctus du myocarde aigu lié à l’artère interventriculaire antérieur. Les résultats
de l’angiographie coronarienne nous ont amenés à suspecter une occlusion thrombotique
d’une petite branche de l’ACD ectasique résultant d’un flux lent. Le diagnostic final
a été confirmé au moyen de la coronarographie par tomodensitométrie et l’imagerie
cardiaque par résonance magnétique, ce qui souligne le rôle essentiel du diagnostic
obtenu par ces modalités d’imagerie.
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References
- Isolated acute occlusion of a large right ventricular branch of the right coronary artery following coronary balloon angioplasty: the only true “model” to study ECG changes in acute, isolated right ventricular infarction.Eur Heart J. 1996; 17: 247-250
- Isolated right ventricular infarction due to occlusion of the right ventricular branch in the absence of percutaneous coronary intervention.Can J Cardiol. 2008; 24: 793-794
- Value of electrocardiogram in diagnosing right ventricular involvement in patients with an acute inferior wall myocardial infarction.Br Heart J. 1983; 49: 368-372
Article info
Publication history
Published online: January 02, 2014
Accepted:
December 23,
2013
Received:
November 25,
2013
Footnotes
See page 464.e10 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
