CLINICAL MANIFESTATIONS OF RIGHT VENTRICULAR INFARCT IN PATIENTS OF INFERIOR WALL MYOCARDIAL INFARCTION

ABSTRACT Objective: To determine the clinical manifestations of right ventricular infarct in patients of inferior wall myocardial infarction. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted at AFIC and NIHD Rawalpindi, from Jul 2017 to Jun 2018. Material and Methods: Patients with inferior wall myocardial infarction were enrolled. Data regarding age, gender, clinical presentation especially typical chest pain, decreased level of consciousness, hypotension, raised jugular venous pressure and changes in standard 12 lead ECG along with right sided leads were noted. Patients with previous history of any myocardial infarction, chronic kidney disease and chronic liver disease or hypotension were excluded from the study and patients with electrolyte imbalances were also excluded from the study. Data was entered and analysed using SPSS-21. Results: A total of 264 patients of inferior wall MI were enrolled out of whom 82 (31%) had inferior wall MI with RV infarction and 182 (69%) had inferior wall MI without RV infarction. The mean age of the patients was 56.95 ± 8.9 years. In patients of inferior wall myocardial infarction with right ventricular involvement, chest pain, hypotension, raised JVP and decreased level of consciousness was seen in 79 (96.3%), 51 (62.1%), 18 (21.9%), 16 (19.5%) respectively while in patients with no right ventricular involvement chest pain, hypotension, raised JVP and decreased level of consciousness was seen in 179 (98.3%), 2 (1%), 7 (3.84%), 3 (1.64%) respectively. Conclusion: The results showed that chest pain, decreased level of consciousness, hypotension, raised JVP were more frequent in inferior MI with RV involvement patients as compared to inferior MI without RV involvement.