ABSTRACT
BACKGROUND: Little information is available about the relation between right ventricular infarction (RVI) and the presence of atrioventricular block. Thus, the objective of this study was to analyse a possible correlation between the conditions, which are frequently associated with inferior acute myocardial infarction (AMI). METHODS: We studied 107 patients with inferior AMI, of whom 49 had RVI, assessed by ST-segment elevation in right precordial leads (V3R-V4R) and by technetium-99m (99mTc) pyrophosphate scintigraphy. The diagnosis of atrioventricular block was made by continuous ECG monitoring during the first week of admission. RESULTS: The patients were divided into two groups: group A with RVI and group B with isolated inferior AMI. These groups were similar regarding sex, age, coronary risk factors, and time from the onset of precordial pain to hospital admission. Group A had a predominance of atrioventricular block (61.2 versus 15.5%, P < 0.0004), peak creatine kinase MB (82.5 +/- 22.4 versus 65.2 +/- 25.1 IU/l, P < 0.05), congestive heart failure or cardiogenic shock (57.1 versus 18.9%, P < 0.002), and proximal right coronary artery occlusion (80.4 versus 25.0%, P < 0.001). Non-Q-wave infarction was more frequent in group B patients (14.2 versus 34.4%, P < 0.01). The mortality rate was similar in the two groups (12.2 versus 13.7%). CONCLUSIONS: These data suggest that infarction extension from inferior wall to the right ventricle may be related to the development of atrioventricular block and does not increase mortality.
Subject(s)
Heart Block/complications , Myocardial Infarction/complications , Aged , Cineangiography , Coronary Angiography , Female , Heart Block/diagnostic imaging , Heart Block/physiopathology , Heart Ventricles , Humans , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/mortality , Myocardial Infarction/physiopathology , Ventricular Function, RightSubject(s)
Heart Ventricles/drug effects , Hypertension/drug therapy , Pindolol/pharmacology , Propranolol/pharmacology , Adult , Female , Heart Ventricles/diagnostic imaging , Hemodynamics/drug effects , Humans , Hypertension/physiopathology , Male , Middle Aged , Phonocardiography , Radiography , TechnetiumSubject(s)
Humans , Male , Female , Adult , Middle Aged , Phonocardiography , Pindolol , Propranolol , Hypertension , Heart VentriclesSubject(s)
Adult , Middle Aged , Humans , Male , Female , Acebutolol , Hypertension , Antihypertensive AgentsSubject(s)
Humans , Male , Female , Adult , Middle Aged , Pindolol , Hypertension , Heart Ventricles , Phonocardiography , Arterial PressureSubject(s)
Humans , Male , Female , Adult , Middle Aged , Chlorthalidone , Acebutolol , HypertensionSubject(s)
Humans , Male , Middle Aged , Propylene Glycols , Cineangiography , Technetium , Exercise Test , Heart VentriclesSubject(s)
Heart Defects, Congenital/physiopathology , Phonocardiography , Ductus Arteriosus, Patent/physiopathology , Ebstein Anomaly/physiopathology , Humans , Tetralogy of Fallot/physiopathology , Transposition of Great Vessels/physiopathology , Tricuspid Valve/abnormalities , Trilogy of Fallot/physiopathologySubject(s)
Aortic Valve Stenosis/diagnosis , Heart Defects, Congenital/diagnosis , Phonocardiography , Pulmonary Valve Stenosis/diagnosis , Aortic Coarctation/diagnosis , Aortic Valve Stenosis/congenital , Ductus Arteriosus, Patent/diagnosis , Heart Septal Defects/diagnosis , Humans , Lutembacher Syndrome/diagnosis , Pulmonary Valve Stenosis/congenitalSubject(s)
Aging , Phonocardiography , Ventricular Function , Aged , Female , Heart Rate , Humans , Male , Middle Aged , Myocardial Contraction , Sex FactorsABSTRACT
Atraves da fonomecanocardiografia, estudou-se o desempenho ventricular esquerdo em 66 individuos assintomaticos, 26 do sexo masculino e 40 do sexo feminino, com idades variaveis entre 60 e 84 anos. Os gerontes foram divididos em dois grupos de acordo com a idade: grupo I - 37 casos com 60 a 69 anos e grupo II - 29 casos com 70 anos ou mais. Separaram-se os casos com eletrocardiograma e area cardiaca normais, daqueles com alteracoes. Os dados obtidos foram comparados entre si e com os de adultos jovens normais. O tratamento estatistico permitiu diversas conclusoes: 1) houve tendencia a bradicardia sinusal,principalmente nos homens e nos pacientes com tracado eletrocardiografico alterado; 2) os parametros sistolicos do ventriculo esquerdo tenderam a alterar-se mais nos homens; 3) observou-se relacao entre alteracao dos parametros sistolicos e area cardiaca aumentada, porem nao houve relacao com eletrocardiograma alterado; 4) o quociente sistolico mesmo nos idosos com eletrocardiograma e area cardiaca normais foi significativamente mais elevado que nos jovens normais. Os resultados demonstram o comprometimento miocardico do idoso, principalmente nos homens,mesmo na ausencia de cardiopatia evidente