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Right ventricular myocardial infarction

Thomas Levin, MD
James A Goldstein, MD
Section Editors
Freek Verheugt, MD, FACC, FESC
Donald Cutlip, MD
Deputy Editor
Gordon M Saperia, MD, FACC


Acute myocardial infarction (MI) involving only the right ventricle is an uncommon event. More often, right ventricular MI (RVMI) is associated with acute ST-elevation myocardial infarction of the inferior wall of the left ventricle, and occurs in 30 to 50 percent of such cases [1-6].

RVMI is associated with higher in-hospital morbidity and mortality compared with patients with a similar infarction territory in the left ventricle but that does not involve the right ventricle. Poor outcome is usually related to profound hemodynamic and electrical complications, which occur in approximately 50 percent of affected individuals [1-9]. However, long-term prognosis is generally good for those who survive the event.

This topic will discuss the diagnosis and management of patients with RVMI. The general approach to patients with MI is found elsewhere. (See "Overview of the acute management of non-ST elevation acute coronary syndromes" and "Overview of the acute management of ST-elevation myocardial infarction" and "Overview of the non-acute management of ST elevation myocardial infarction" and "Overview of the non-acute management of unstable angina and non-ST elevation myocardial infarction".)


Definitions — The following terms that are used in this topic are defined as follows:

Stroke volume is the amount of blood pumped with each beat. It is influenced by preload, afterload, and contractility. (See "Pathophysiology of heart failure: Left ventricular pressure-volume and other hemodynamic relationships", section on 'Normal left ventricular pressure-volume relationship'.)

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Literature review current through: Nov 2017. | This topic last updated: Oct 23, 2017.
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