| Right ventricular involvement in myocardial infarction and cardiogenic shock. | |
| | |
MedLine Citation:
|
PMID: 12907014 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
CONTEXT: Right ventricular involvement in acute myocardial infarction and cardiogenic shock has received little attention by clinicians and researchers, although its pathophysiology, clinical presentation, and natural history are distinctly different from those of left ventricular infarction and associated cardiogenic shock. Right ventricular shock has important therapeutic implications for the management of patients, which need to be recognised. STARTING POINT: Investigators at the SHOCK Registry (Alice Jacobs and colleagues, J Am Coll Cardiol 2003; 341: 1273-79) evaluated 49 patients with cardiogenic shock predominantly due to right ventricular infarction and compared them with 884 patients with cardiogenic shock and predominantly left ventricular failure. Perhaps surprisingly, these investigators found that the in-hospital mortality of patients with right ventricular shock was not significantly lower than that of patients with left ventricular shock (53% vs 61%, p=0.296), despite the fact that patients with right ventricular shock were younger, with a lower prevalence of previous infarctions, fewer anterior infarct locations, and less multivessel disease. There was a shorter median time between index infarction and diagnosis of shock in patients with right ventricular shock. In multivariate analysis, right ventricular shock was not an independent predictor of lower in-hospital mortality. WHERE NEXT? The unexpectedly high mortality of patients with cardiogenic shock due to predominantly right ventricular infarction challenges the general notion that right ventricular involvement in myocardial infarction has only little relevance for patient's outcome. Therefore, more attention should be given to the detection of right ventricular involvement in acute myocardial infarction and particularly in cardiogenic shock. If right ventricular shock is diagnosed, urgent reperfusion of the infarct related artery and appropriate circulatory support are required. |
| | |
Authors:
|
Matthias Pfisterer |
Related Documents
:
|
9607464 - Current concepts of ventricular defibrillation. 2804784 - Clinical experience with percutaneous intra-aortic balloon pumping in cardiogenic shock... 17384884 - Aggressive management of acute myocardial infarction: successful outcome in an older pa... 17396734 - Anaphylactic shock: the great mimic. 11123134 - Myocardial infarction due to coronary abnormalities in pulmonary atresia with intact ve... 77854 - Detection, quantitation and contrast enhancement of myocardial infarction utilizing com... |
Publication Detail:
|
Type: Case Reports; Journal Article; Review |
Journal Detail:
|
Title: Lancet Volume: 362 ISSN: 1474-547X ISO Abbreviation: Lancet Publication Date: 2003 Aug |
Date Detail:
|
Created Date: 2003-08-08 Completed Date: 2003-08-25 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 2985213R Medline TA: Lancet Country: England |
Other Details:
|
Languages: eng Pagination: 392-4 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiology, University Hospital, CH-4031, Basel, Switzerland. pfisterer@email.ch <pfisterer@email.ch> |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Electrocardiography / statistics & numerical data Heart Ventricles / physiopathology* Hospital Mortality Humans Male Myocardial Infarction / diagnosis, mortality, physiopathology* Prognosis Shock, Cardiogenic / diagnosis, mortality, physiopathology* Ventricular Dysfunction, Right / diagnosis, mortality, physiopathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coeliac disease.
Next Document: Euthanasia and other end-of-life decisions in the Netherlands in 1990, 1995, and 2001.