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Cardiogenic Shock Complicating
Right Ventricular Myocardial Infarction

Arango, J.J.; Velásquez, J.G.; Arana, C.;
Villegas, M.F.; Badiel, M.; Rosso, F.

Cardiology Interventional Laboratory in the Foundation
Clinic Valle del Lili.- Cali - Colombia

Introduction: The Right Ventricular Myocardial Infarction (RVMI) with Cardiogenic Shock has a poor prognosis and high mortality despite the management with new invasive procedures and new drugs. New investigations have been suggested that early reperfusion with invasive therapy could reduce this mortality.

Purpose: Assess incidence, prognosis and characteristics of the patients with RVMI in our hospital.

Design: Historic Cohort.

Site: Cardiology Interventional Laboratory in the Foundation Clinic Valle del Lili.

Materials and Methods: Retrospective case series from February 1994 to March 1999. Patients with acute myocardial infarction and RCA as culprit artery, ECG criteria and cardiogenic shock (SBP <80mmHg) were included. The end points were clinical outcomes and hospital survival.

Results: From Febreruary/94 to March/99 were performed an interventional procedure in 1250 patients in acute coronary events. Eleven patients (0.8%) had Cardiogenic Shock complicating RVMI. Mean age was 63.3 ± 5.9 years (49 - 72). 81.8% were men. Five had CAD as antecedent. Mean LVEF (at admission) was 27.5% (15 - 40%). All patients were performed primary PTCA and was successful in 91% (10/11). Adjunctive therapy in Intensive Care Unit included: mechanical ventilation and vasoactives in 100%, IABP 45% (5/11), transitory pacemaker in 27.27% (3/11), Cardioversion in 9% (1/11). Hospital survival was 72%.

Conclusions: The incidence of Right Ventricular Myocardial Infarction is very low in our hospital. The mortality was high. For this reason, early and aggressive reperfusion with invasive procedure should be performed.

 

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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
President
Dr. Raúl Bretal
Scientific Committee
President
Dr. Armando Pacher
Technical Committee - CETIFAC
President
fgaro@fac.org.ar
fgaro@satlink.com
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rbretal@netverk.com.ar
apacher@fac.org.ar
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Copyright© 1999-2001 Argentine Federation of Cardiology
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