Complications and mortality in hospitalized patients with acute inferior myocardial infarction with or without right ventricular involvement

Abstract

Assessment of complications, mortality and prognostic impact of Right Ventricular (RV) myocardial involvement in patients with inferior MI. Eighty five patients who were admitted to cardiac care unit (CCU) of Yarmook teaching hospital with the diagnosis of first inferior MI with (group 1) or without simultaneous involvement of RV (group 2) from 2006 to 2007, Patients who had simultaneous Anterior wall MI, previous MI, patients with chronic lung diseases, and those with renal impairment (creatinine >2 mg/dl), any active bleeding or trauma , The presence of ECG findings including presence of STSEs of <1mm in the inferior leads, STSEs in the leads other than the inferior leads, left ventricular hypertrophy (LVH), left bundle branch block (LBBB) were excluded. Fifty percent of patients in group 1 developed complete heart block which was significantly higher than group 2 (P< 0.001), cardiogenic shock incidence in group 1 was significantly higher than group 2 (P < 0.05), Mortality was higher in the patients with inferior infarction extended to the RV (16.66% vs. 4.65%. P= 0.0001). There was no a meaningful difference in incidence of LBBB and RBBB between group 1 and 2, There is no significant differences in incidences of arrhythmias; Sinus tachycardia, Sinus bradycardia, Atrial premature contraction, Atrial fibrillation, Ventricular tachycardia Ventricular fibrillation, 1st degree heart block 2nd degree heart block. Conclusion: because of high incidence of complications and high mortality rate of patients with inferior myocardial infarction with right ventricular infarction, early diagnosis of RV infarction is mandatory to choose the correct management which differs from that of left ventricular infarctions