The diagnosis, management and treatment of right ventricular myocardial infarction (MI) is significantly different to the more commonly encountered acute MI which primarily involves the left ventricle. A right ventricular MI often occurs concommitantly as an inferior or posterior wall acute MI, thereby endangering a larger area of myocardium. The electrocardiogram (ECG) is a powerful clinical tool in the diagnosis of acute MI. However, the standard 12-lead ECG does not provide an effective view of the right ventricular wall. It is therefore important to carefully interpret the standard 12-lead ECG if right ventricular MI is suspected. In this article the addition of right precordial leads is recommended to improve diagnosis and the research supporting this practice is discussed. The classic symptoms that are associated with inferior or posterior wall infarction: hypotension, raised jugular venous distension and clear lung fields are also strong indicators of right ventricular MI. Early diagnosis is essential as the haemodynamic consequences and management of right ventricular MI and an infarction primarily affecting the left ventricle may be markedly different. This article will discuss the importance of ensuring that the correct treatments are provided as there may be serious adverse affects if a a misdiagnosis is made and incorrect treatment given.
- right ventricular myocardial infarction, electrocardiogram, right sided ECG leads