Isolated Right Ventricular Infarct Presenting as Ventricular Fibrillation Arrest and Confirmed by Delayed-Enhancement Cardiac MRI

João L. Cavalcante, Mouaz Al-Mallah, Michael Hudson

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Malignant ventricular arrhythmias resulting from isolated right ventricular myocardial infarction (RVMI) without left ventricular myocardial ischaemia or infarction occur rarely. We present a case of a 61 year-old male with acute onset of chest pain and ventricular fibrillation cardiac arrest requiring prompt defibrillation. Subsequent 15-lead EKG, showed ST-segment elevation in the anterior and right precordial leads without ST-segment elevation in the inferior leads. Angiography documented occlusion of a large RV marginal branch. Delayed enhancement cardiac magnetic resonance imaging (DE-CMR) with gadolinium performed two days post-infarct showed isolated RVMI. Patient remained symptom free and haemodynamically stable throughout his hospital stay. The clinical presentation of isolated RV infarct can be misleading and diagnosis difficult. EKG findings can resemble acute anterior wall myocardial infarction, while its course can be accompanied by life-threatening ventricular arrhythmias. This case uniquely combines this rare clinical sequence with DE-CMR images using gadolinium to confirm isolated RVMI. A brief review of RVMI presentation and associated EKG patterns is also discussed.

Original languageEnglish (US)
Pages (from-to)620-623
Number of pages4
JournalHeart Lung and Circulation
Volume19
Issue number10
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • Anterior ST segment elevation
  • Cardiac magnetic resonance
  • Right ventricle infarct
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Isolated Right Ventricular Infarct Presenting as Ventricular Fibrillation Arrest and Confirmed by Delayed-Enhancement Cardiac MRI'. Together they form a unique fingerprint.

Cite this