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Case Reports
. 2019 Mar;60(3):124-129.
doi: 10.11622/smedj.2019026.

Isolated right ventricle infarction

Jia Wei Woo  1 , William Kong  1 , Anand Ambhore  1 , Saurabh Rastogi  2 , Kian Keong Poh  1 , Poay Huan Loh  1
Affiliations
Case Reports

Isolated right ventricle infarction

Jia Wei Woo et al. Singapore Med J. 2019 Mar.

Abstract

We described two patients who were successfully resuscitated from out-of-hospital cardiac arrest. Their ECGs showed ST elevations in V1 and aVR, as well as diffuse ST depression. Their ST elevation in V1 was noted to be greater than in aVR. While one patient was found to have an occlusion of the right ventricular (RV) branch of the right coronary artery, the other was found to have an occlusion of a proximal non-dominant right coronary artery supplying the RV branch. Successful primary percutaneous coronary intervention was performed for each patient with angioplasty and implantation of a drug-eluting stent. Both patients made good physical and neurological recovery.

Keywords: ECG; RV branch occlusion; isolated right ventricular infarction; out-of-hospital cardiac arrest.

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Figures

Fig. 1
Fig. 1
Case 1: Patient’s ECG on presentation.
Fig. 2
Fig. 2
Case 1: (a) Initial coronary angiogram shows the proximal occlusion of the right ventricular (RV) branch of the right coronary artery (arrow). (b) Coronary angiogram shows good flow into the RV branch of the right coronary artery post angioplasty (arrow).
Fig. 3
Fig. 3
Case 1: Right-sided chest leads of the patient show subtle ST elevation in V4R, V5R and V6R.
Fig. 4
Fig. 4
Case 1: Echocardiograms show (a) right ventricular (RV) systolic excursion velocity of 8 cm/second (arrow), suggesting moderate RV systolic dysfunction; and (b) tricuspid annular plane systolic excursion of 13 mm, indicating mild to moderate reduction in RV systolic function.
Fig. 5
Fig. 5
Case 2: Initial ECG of the patient shows ST elevation in V1 that is higher than the ST elevation in aVR.
Fig. 6
Fig. 6
Case 2: (a) Initial coronary angiogram shows occlusion of the proximal non-dominant right coronary artery (RCA; arrow). (b) Post-intervention coronary angiogram shows good flow in the proximal non-dominant RCA (arrow).
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