Document Detail


Inferior wall myocardial infarction with or without right ventricular involvement--treatment and in-hospital course.
MedLine Citation:
PMID:  16810575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Piotr Kukla; Dariusz Dudek; Tomasz Rakowski; Artur Dziewierz; Waldemar Mielecki; Kazimierz Szczuka; Jacek S Dubiel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  64     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-30     Completed Date:  2006-12-27     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  583-8; discussion 589-90     Citation Subset:  IM    
Affiliation:
Oddział Wewnetrzny, Szpital Specjalistyczny, ul. Wegierska 21, 38-300 Gorlice, Poland. kukla_piotr@poczta.onet.pl
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MeSH Terms
Descriptor/Qualifier:
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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