Right ventricular myocardial infarction other imaging findings

Right ventricular myocardial infarction Microchapters
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Overview
Pathophysiology
Pathophysiology of Reperfusion
Gross Pathology
Histopathology
Causes
Differentiating Right ventricular myocardial infarction from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Electrocardiogram
Chest X Ray
Echocardiography or Ultrasound
Coronary Angiography
Other Imaging Findings
Treatment
Initial Care
Pharmacological Reperfusion
Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)
Fibrinolysis
Mechanical Reperfusion
The Importance of Reducing Door-to-Balloon Times
Primary PCI
Adjunctive and Rescue PCI
Rescue PCI
Facilitated PCI
Adjunctive PCI
CABG
Management of Patients Who Were Not Reperfused
Assessing Success of Reperfusion
Antithrombin Therapy
Antithrombin Therapy
Unfractionated Heparin
Low Molecular Weight Heparinoid Therapy
Direct Thrombin Inhibitor Therapy
Factor Xa Inhibition
DVT Prophylaxis
Long Term Anticoagulation
Antiplatelet Agents
Aspirin
Thienopyridine Therapy
Glycoprotein IIbIIIa Inhibition
Other Initial Therapy
Inhibition of the Renin-Angiotensin-Aldosterone System
Magnesium Therapy
Glucose Control
Calcium Channel Blocker Therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Other Imaging Findings

Radionuclide ventriculography and technetium-99m-pyrophosphate scanning

• These techniques have acceptable sensitivities and specificities for making a diagnosis of right ventricular infarction. Radionuclide angiography can detect wall motion abnormalities and hypoperfusion in the affected right ventricle. It can also be used to quantitate both left and right ventricular ejection fractions. Technetium scanning, on the other hand, is particularly useful for late diagnosis, as it shows areas of necrotic or dying myocardium.
• However, both methods are cumbersome and time consuming. They are also frequently difficult to perform at the bedside, particularly when the patient is unstable in the intensive care unit and nuclear cardiology equipment is not readily portable. Thus, these tests are best performed later in the course to further quantify the degree of right ventricular infarction and dysfunction.