Prognosis and evolution in the right ventricular infarction

Abstract

The clinical evaluation, hemodynamic, and progression of patients with ST-segment elevation acute myocardial infarction (STEMI) and right ventricular involvement remains a challenge. Timely reperfusion changes the prognosis; however, there are other determining factors of evolution, such as the presence of greater hemodynamic deterioration requiring invasive management, increased biventricular failure, complications such as atrioventricular block, renal failure, and higher mortality. The authors observed a worse prognosis in the right ventricular infarction (RVI) group in a cohort of 1,126 patients, of which 9.6% (149 patients) had this condition. Although between 75% and 76% underwent primary angioplasty and 5% fibrinolytic therapy, with no significant difference between both groups, mortality was three times higher in patients with right ventricular infarction (15.4% vs 5.1%, p<0.0001), which implies other pathophysiological and therapeutic conditions in this group of patients.