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Isolated Right Ventricular Myocardial Infarction

Joel K. Kahn, MD; Mark Bernstein, MD; and James R. Bengtson, MD
[+] Article and Author Information

From Michigan Heart and Vascular Institute, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Requests for Reprints: Joel K. Kahn, MD, 2221 Livernois, Suite 103, Troy, MI 48083. Acknowledgments: The authors thank William Bush, DO, for referral of the patients.


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;118(9):708-711. doi:10.7326/0003-4819-118-9-199305010-00009
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Infarction of the right ventricle can be detected in as many as 30% to 40% of patients with inferior myocardial infarction. Infarction involving only the right ventricle is unusual, and the diagnosis has rarely been made early in presentation. We report two patients with myocardial infarction isolated to the right ventricle. Both patients had prolonged chest pain and normal electrocardiograms. In the first patient, urgent cardiac catheterization showed an occluded, nondominant right coronary artery that was reperfused using emergency angioplasty. In the second patient, a subtotally occluded, nondominant right coronary artery caused postinfarction angina and was treated successfully with angioplasty. Patients with prolonged chest pain and nondiagnostic electrocardiograms should be assessed for this rarely reported syndrome.

Figures

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Figure 1.
Contrast coronary angiogram from Patient 1.Left.arrowRight.

Selective injection of the right coronary artery in the left, anterior oblique projection. Total proximal obstruction is seen ( ). After percutaneous transluminal coronary angioplasty, flow is restored to this nondominant artery supplying only the right ventricle.

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Figure 2.
Contrast coronary angiogram from Patient 2.Left.arrowRight.

Selective injection of the right coronary artery in the left, anterior oblique projection. A subtotal obstruction is present in the proximal portion of this nondominant artery ( ) supplying only the right ventricle. After percutaneous transluminal coronary angioplasty, the narrowing improved.

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