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

R. Zerhoudi, B. Maatof, H. Nabawi, Y. Islah, M. Eljamili, S. Karimi, M. Elhattaoui
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Abstract

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.
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右心室梗死的电、超声心动图和冠状动脉特征:马拉喀什朱穆罕默德六世心内科的经验
导语:冠心病是世界范围内发病率和死亡率的主要原因。右心室(RV)梗死通常难以诊断,并且由于节律和血流动力学并发症而预后不良。目的:探讨VD梗死的电、超声、冠状造影特征。材料和方法:回顾性研究在马拉喀什穆罕默德六世大学医院心内科住院的24个月MDI扩展到右心室的患者。结果:120例患者在此期间因心肌梗死延伸至VD而住院。10%的病例有不典型临床表现。入院时的临床检查显示18%的病例有右心衰的迹象,其中6%合并心源性休克。10%的患者进行了溶栓,67%的患者成功。心电图显示76%的病例有孤立的V3R导联延伸,45%的病例有V4R超调,28%的病例有传导障碍,主要表现为一级耳室传导阻滞。超声心动图显示82%的病例左室功能受损,65%的病例左室纵向收缩功能障碍。91%的病例行冠状动脉造影,其中一半行冠状动脉成形术。在40%的病例中发现了CD和IVA损伤的组合,而在几乎一半的病例中,中间DC损伤最为常见。最常见的并发症是节律性和传导性障碍,占38%,演变为致命的病例占8%。结论:心肌梗死期间右心室受累的特征是一个非常关键的初始阶段,一旦克服,从长远来看,整体预后是良好的。
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