Electrical, Echocardiographic and Coronary Artery Characteristics of Right Ventricular Infarction: Experience of the Cardiology Department of the CHU Mohammed VI Marrakech

Introduction: Coronary heart disease is the main cause of morbidity and mortality worldwide. Right ventricular (RV) infarction is often difficult to diagnose and has a poor prognosis due to rhythmic and hemodynamic complications.

Objective: The study of electrical, ultrasonographic, and coronarographic features of the VD Infarction.

Materials and Methods: Retrospective study of patients hospitalized in the Cardiology Department of the Mohammed VI University Hospital in Marrakech over a period of 24 months for MDI extended to the RV.

Results: 120 patients were hospitalized during this period for MI with extension to the VD. Atypical clinical presentation was noted in 10% of cases. Clinical examination on admission revealed signs of right heart failure in 18% of cases, including 6% complicated by cardiogenic shock. Thrombolysis was performed in 10% of the patients, 67% of them successfully. The ECG found an isolated extension to the V3R leads in 76% of the cases and in association with a V4R overshoot in 45% of the cases, conduction disorders were noted in 28% of the cases, presented essentially by first degree auriculoventricular block. Echocardiography showed impaired LV function in 82% of cases, and longitudinal systolic dysfunction of the LV in 65%. Coronary angiography was performed in 91% of the cases, half of which underwent coronary angioplasty. The combination of both CD and IVA damage was found in 40% of the cases, and damage to the middle DC was the most common in almost half of the cases. The most frequent complications were rhythmic and conductive disorders in 38% of cases, and the evolution was fatal in 8% of cases.

Conclusion: Involvement of the RV during MI is characterized by a very critical initial phase, once overcome, the overall prognosis becomes favorable in the long term.