Interv Akut Kardiol. 2006;5(1):27-30

ACUTE RIGHT VENTRICULAR MYOCARDIAL INFARCTION WITH MULTIORGAN DYSFUNCTION SYNDROME

Jan Bruthans¹, Karel Goričan²

¹ Interní oddělení Podřipské nemocnice Roudnice nad Labem, s. ,r. ,o., Roudnice nad Labem

² IV. interní klinika VFN a 1. LF UK, Praha

A 64-year-old woman with acute right ventricular myocardial infarction (RVMI) in combination with inferior wall myocardial infarction was admitted to the intensive care unit of her catchment area hospital and treated with antiaggregants, heparin intensive volume therapy, and catecholamines. On the following day, the patient was transferred to the coronary unit of terciary center where PCI with recanalization and stenting of the right coronary artery was performed, massive fluid administration and catecholamine support were continued and CVVHD and temporary right atrial based cardiac stimulation were performed. Diuresis was re-established and blood pressure was stabilized, in the following days laboratory parameters gradually returned to normal and physical rehabilitation was initiated. Following discharge, physical performance as well as volume and contractile parameters of both ventricles improved over time.

According to the literature, in right ventricular infarction the viability of the myocardium remains preserved and the efficiency of the right ventricle improves and subsequently settles even without early reperfusion. The data on performing and effects of early reperfusion in RVMI have been less frequent than in the case of left ventricular infarction. In severe RVMI with multiorgan failure, direct PCI in combination with other therapeutic procedures is the method to reverse an otherwise apparently fatal course.

Keywords: right ventricular infarction, multiorgan failure, percutaneous coronary intervention

Published: January 1, 2006  Show citation