When right ventricular failure occurs as a result of right ventricular myocardial
infarction (RVMI) [
[1]
], its manifestations can be closely simulated by right ventricular failure attributable
to pulmonary embolism (PE) [
[2]
,
[3]
]. In the latter example of PE-related right ventricular failure a 35 year old previously
healthy woman (a non-smoker) presented with severe abdominal pain and abdominal distension,
but denied dyspnea or chest pain. Exploratory laparotomy revealed that she had a congested
and very enlarged liver, and ascites as well. Further investigations included echocardiography,
which disclosed a right ventricular systolic pressure of 77 mm Hg, and tricuspid regurgitation.
These derangements were attributable to right ventricular failure resulting from massive
PE [
[3]
]. According to Namana et al., RVMI most closely simulates PE when it presents with
“chest pain, diaphoresis, nausea and vomiting with [the] hemodynamic triad:hypotension,
jugular venous distension and clear lung fields” [
[2]
]. Dysrhythmias which occur in RVMI, such as atrial fibrillation and complete heart
block [
[4]
], also occur in PE [
[5]
,
[6]
].To read this article in full you will need to make a payment
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References
- Dysrhythmias and heart failure complicating acute myocardial infarction: an emergency medicine review.Am J Emerg Med. 2019; ([Article in Press])
- Right ventricular infarction.Cardiovasc Revasc Med. 2018; 19: 41-50
- Acute surgical abdomen: an unusual presentation of pulmonary embolus.J Investig Med High Impact Case Rep. 2014; https://doi.org/10.1177/2324709614542339
- Pathophysiology and management of right heart ischemia.JACC. 2002; 40: 841-853
- Pulmonary embolism and atrial fibrillation: two sides of the same coin? A systematic review.Semin Thromb Hemost. 2017; 43: 849-863
- Syncope and complete atrioventricular block related to pulmonary thromboembolism.Arq Bras Cardiol. 2004; 83: 438-441
- A reversible cause of hypoxaemia in a patient with acute right ventricular infarction.Hellenic J Cardiol. 2019; ([Article in press])
- The dilemna of refractory hypoxemia after inferior wall myocardial infarction.Proc Baylor Univ Med Cent. 2018; 31: 67-69
Article Info
Publication History
Published online: May 31, 2019
Accepted:
May 30,
2019
Received in revised form:
May 29,
2019
Received:
May 17,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
