RSS Feeds
Isolated Right Ventricular Infarction
- David M. Zientek, MD; and
- Carl E. Eybel, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Kahn and colleagues [1] described two patients with isolated right ventricular infarction due to a lesion in a nondominant right coronary artery who were treated with angioplasty. Both presented with normal 12-lead electrocardiograms, although the second developed atrial fibrillation.
We previously described a similar patient who presented with atrial fibrillation and isolated ST-segment elevation in lead V1 with inferolateral ST depression [2]. Isolated right ventricular infarction was confirmed by creatine kinase elevation, echocardiography, and right-heart catheterization. Post-infarction angina led to cardiac catheterization, which showed a codominant circulation with an anomalous right coronary artery arising from the left coronary cusp. Coronary angioplasty was done successfully on an 85% proximal stenosis of the right coronary artery, and the sinoatrial nodal artery appeared to originate distal to the lesion.
We agree that isolated right ventricular infarction may be an under-recognized entity because patients may have normal or unusual electrocardiographic findings. Atrial fibrillation has been described previously in patients with isolated right ventricular infarction [3], as might be expected from the usual origin of the sinus nodal artery from the right coronary artery. The combination of symptoms compatible with infarction, new-onset atrial fibrillation, and a normal 12-lead electrocardiogram or isolated ST elevation in lead VI would suggest isolated right ventricular infarction. Echocardiography and right-sided electrocardiographic leads may aid in diagnosis, as may right-heart catheterization in patients with hemodynamic compromise. The increased availability of angioplasty will undoubtedly lead to such treatment if the condition is recognized.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright 2004 by the American College of Physicians
