Correlation between echocardiographic and primary percutaneous coronary intervention for proximal right coronary artery in inferior-wall myocardial infarction

Background Diagnosing myocardial infarction (MI) of the right ventricle (RV) is difficult. ECG remains the main tool for diagnosis of acute RVMI. For accurate diagnosis of RVMI, angiography can be done to enforce RVMI diagnosis. The physiology of the RV makes it less likely to suffer muscle infarction, but this can happen in cases of acute severe right coronary-artery (RCA) occlusion. Echocardiographic parameters have proven their efficacy in predicting proximal RCA infarction, including annular velocity and tricuspid annular-plane systolic excursion. Aim Assessment of the value of RV echocardiographic parameters in the diagnosis of early acute inferior RVMI in relation to coronary angiogram of proximal RCA. Patients and methods This prospective study was conducted on 125 patients diagnosed with inferior MI. ECG, echocardiographic RV parameters, and primary percutaneous coronary-intervention technique for proximal RCA were performed for all included patients at the Cardiovascular Medicine Department Tanta University Hospitals from June 2019 to December 2019. Results RV infarction occurred mostly in cases of proximal RCA occlusion and few cases with mid-segment of RCA lesion. This was reported by echocardiography using tricuspid annular-plane systolic excursion and S-wave tissue Doppler. Few cases showed impairment in RV function in left circumflex-artery occlusion as culprit vessel reported by echocardiography and the impairment occurred only with S wave. RV function was not affected with left circumflex-artery occlusion as culprit lesion. Conclusion Echocardiographic parameters of RV are useful in predicting RVMI due to proximal RCA occlusion.