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Case Reports
. 2022 Feb 17:2022:2462781.
doi: 10.1155/2022/2462781. eCollection 2022.

Right Ventricular Myocardial Infarction Complicated by Cardiac Arrest: Utilization of Extracorporeal Membrane Oxygenation

Alisha Alabre-Bonsu  1 , Saurav Uppal  1 , Ernest L Mazzaferri Jr  1 , Konstantinos Dean Boudoulas  1
Affiliations
Case Reports

Right Ventricular Myocardial Infarction Complicated by Cardiac Arrest: Utilization of Extracorporeal Membrane Oxygenation

Alisha Alabre-Bonsu et al. Case Rep Cardiol. .

Abstract

A 44-year-old male with an out-of-hospital cardiac arrest due to an acute left ventricular (LV) inferoposterior wall myocardial infarction (MI) involving the right ventricle (RV) is presented. This case highlights the challenges in the management of patients with cardiac arrest, indications for use of ventricular assist devices, potential effects of LV assist devices on the RV in the setting of RV MI, and culprit versus complete coronary artery revascularization in these patients.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Diagnostic arteriogram demonstrating acute complete thrombotic occlusion in the proximal right coronary artery (arrow) representing the culprit lesion and (b) 90% stenosis in the proximal left anterior descending (LAD) coronary artery (arrow) and 95% stenosis in the mid LAD (double arrow). (c) Coronary arteriogram post-percutaneous coronary intervention (PCI) of the RCA with placement of drug eluting stents with restoration of coronary blood flow. (d) Coronary arteriogram post-PCI of the proximal and mid LAD with placement of drug eluting stents.
Figure 2
Figure 2
(a) Transthoracic echocardiogram (TTE) 3-chamber showing the Impella CP percutaneous left ventricular assist device (arrows) within the left ventricle (LV). (b) TTE short axis view demonstrating septal flattening (arrows) indicating right ventricular (RV) pressure/volume overload; the RV is dilated as well. (c) TTE M-mode of the tricuspid annulus showing decreased (dashed line) tricuspid annular plane systolic excursion (TAPSE) of 0.73 cm suggesting RV dysfunction.
Figure 3
Figure 3
Electrocardiogram obtained upon arrival to the cardiovascular intensive care unit demonstrating supraventricular tachycardia (ectopic atrial versus junctional tachycardia), early R-wave transition in the precordial leads, diffuse ST and T wave changes, and QT prolongation most likely secondary to myocardial injury/ischemia and metabolic abnormalities due to cardiac arrest.
See this image and copyright information in PMC

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