| Inferior wall myocardial infarction with or without right ventricular involvement--treatment and in-hospital course. | |
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MedLine Citation:
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PMID: 16810575 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Right ventricular infarction (RVI) is most commonly associated with inferior wall infarction (20-50% of cases). Clinical presentation of RVI may vary. AIM: Assessment of outcome and clinical course of myocardial infarction in patients with inferior wall myocardial infarction with or without RVI. Additionally, risk stratification was attempted in the above-mentioned groups of patients. METHODS: The analysis involved 181 consecutive patients (pts) with inferior wall myocardial infarction hospitalised between 1 July 2000 and 1 July 2002. RESULTS: Nineteen in-hospital deaths were noted in the study group (mortality 10.5%), reinfarction occurred in 6 (3.3%) pts, ischaemic stroke in 1 (0.6%) patient, and 2 (1.1%) pts had transient ischaemic attack. Cardiogenic shock occurred in 20 (11.0%) pts , ventricular fibrillation in 15 (8.3%) pts, and pulmonary oedema in 9 (4.9%) pts. In the subgroup of 161 pts without cardiogenic shock 8 (4.9%) pts died. Thrombolytic therapy was administered in 96 (53%) subjects. Isolated inferior wall myocardial infarction was diagnosed in 94 (51.9%) of 181 pts and RVI in 65 (35.9%) pts. Mortality rate in the RVI group was significantly higher than in inferior wall myocardial infarction without RVI and was 18.5% vs 2.12% (p=0.0003), respectively (excluding patients with cardiogenic shock: 11.1% vs 1.2%, respectively; p=0.016). In patients with RVI aged above 70 years, the mortality rate was significantly higher than in younger patients (32% vs 10%, p=0.002). In a subgroup with RVI treated with thrombolysis mortality was considerably higher in subjects aged >70 years compared to patients below 70 years (38.5% vs 7.7%, p=0.017). CONCLUSIONS: RVI is associated with worse prognosis and increased number of in-hospital complications. Older patients aged >70 years have definitely poorer prognosis. Thrombolytic therapy in a subgroup of older patients with RVI remains ineffective. |
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Authors:
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Piotr Kukla; Dariusz Dudek; Tomasz Rakowski; Artur Dziewierz; Waldemar Mielecki; Kazimierz Szczuka; Jacek S Dubiel |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Kardiologia polska Volume: 64 ISSN: 0022-9032 ISO Abbreviation: Kardiol Pol Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-30 Completed Date: 2006-12-27 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0376352 Medline TA: Kardiol Pol Country: Poland |
Other Details:
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Languages: eng Pagination: 583-8; discussion 589-90 Citation Subset: IM |
Affiliation:
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Oddział Wewnetrzny, Szpital Specjalistyczny, ul. Wegierska 21, 38-300 Gorlice, Poland. kukla_piotr@poczta.onet.pl |
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Angioplasty, Transluminal, Percutaneous Coronary / methods Comorbidity Echocardiography / methods Heart Ventricles / pathology Hospital Mortality Humans Multivariate Analysis Myocardial Infarction / mortality*, radiography, therapy* Myocardial Reperfusion / methods Predictive Value of Tests Prognosis Recurrence Retrospective Studies Survival Analysis Thrombolytic Therapy / methods Treatment Outcome Ventricular Dysfunction, Right / diagnosis, epidemiology*, therapy* Ventricular Function |
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