Key result
Balloon angioplasty of an occluded proximal right coronary artery successfully treated a 73-year-old woman presenting with isolated right ventricular infarction and haemodynamic instability.
Case Report (n=1)
This case highlights the diagnostic challenge of isolated right ventricular infarction, which may present without typical ECG changes and require echocardiography for accurate diagnosis.
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Angioplasty may be feasible in unstable isolated RV infarction; leaves open need for prospective validation beyond this case.
A 73-year-old woman was admitted to the emergency room due to sudden-onset dyspnoea, altered mental status and haemodynamic instability. ECG showed a junctional rhythm, T-wave inversion in I, aVL and V2-V6 (present in a previous ECG), and no ST/T changes in the right precordial leads. Transthoracic echocardiography, however, revealed a severe depression of global systolic function of right ventricle with akinesia of free wall and a normal left ventricular function. Coronary angiography showed an occlusion of the proximal segment of the right coronary artery, which was treated with balloon angioplasty, and a chronic lesion of the anterior descending artery. The patient had a good recovery and was discharged on the 14th day. Myocardial perfusion scintigraphy (stress and rest) was performed a month later, showing a fixed perfusion defect in the apex and anterior wall (medium-apical), with no signs of ischaemia.
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Catarina et al. (2016) conducted a case report in Isolated right ventricular infarction (n=1). Balloon angioplasty was evaluated on Clinical recovery. Balloon angioplasty of an occluded proximal right coronary artery successfully treated a 73-year-old woman presenting with isolated right ventricular infarction and haemodynamic instability.
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