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2016 ; 2016
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Isolated right ventricular infarction: a diagnostic challenge
#MMPMID27143166
Vieira C
; Santa Cruz A
; Arantes C
; Rocha S
BMJ Case Rep
2016[May]; 2016
(ä): ä PMID27143166
show ga
A 73-year-old woman was admitted to the emergency room due to sudden-onset
dyspnoea, altered mental status and haemodynamic instability. ECG showed a
junctional rhythm, T-wave inversion in I, aVL and V2-V6 (present in a previous
ECG), and no ST/T changes in the right precordial leads. Transthoracic
echocardiography, however, revealed a severe depression of global systolic
function of right ventricle with akinesia of free wall and a normal left
ventricular function. Coronary angiography showed an occlusion of the proximal
segment of the right coronary artery, which was treated with balloon angioplasty,
and a chronic lesion of the anterior descending artery. The patient had a good
recovery and was discharged on the 14th day. Myocardial perfusion scintigraphy
(stress and rest) was performed a month later, showing a fixed perfusion defect
in the apex and anterior wall (medium-apical), with no signs of ischaemia.