Clinical Profile and outcome of inferior wall myocardial infarction(IWMI) with special reference to right ventricle involvement

Abstract Introduction: Inferior wall myocardial infarction (IWMI) is unique in its involvement of right ventricle. The incidence varies from 30 % to 50%. Aim: The aim of this study was to survey the clinical profile and prevalence of risk factors in a subgroup of patients with IWMI and incidence of right ventricle involvement who were admitted to the Cardiac ICU. Methods: The analysis involved 91 consecutive patients (pts) with inferior wall myocardial infarction hospitalised between 1 January 2003 and 1 December 2003. Results: Ninety one patients were studied and the mean age was 58 years. There were 70 males and 21 females. 48% (43/91) of the patients had a stay of more than seven days. About 29% (26/91) of the patients presented with atypical symptoms. More than half of patients (51%-14/27) with RV involvement were with atypical symptoms. Eleven (11/91) patients were hemodynamically unstable at presentation, of which five (5/11-46%) of them had RV involvement. Forty one (45%) of them had other wall involvement along with IWMI. Conclusions: Forty three (48%) of patients had a stay more than seven days. In our study the number of deaths were only four (4/91) which was only 4%, Ten (11%) were discharged against medical advice and the rest of them recovered completely. Among deaths two of them had RV involvement and both of them had complete heart block on presentation and one of them presented with a cardiac arrest and was revived initially in emergency room. Right ventricular MI when seen with an IWMI was associated with unusually higher incidence of hypotension 22% (10/27) and 63% (17/27) arrhythmias in the form of atrio-ventricular (AV) blocks or complete heart blocks and sinus bradycardia.