Guidelines Summary

The 2012 European Society of Cardiology (ESC) guidelines for management of patients with ST-segment elevation myocardial infarction (STEMI) notes that elevation of the ST-segment ≥1 mV in V1 and V4R is suggestive of right ventricular infarction.^[45]Echocardiography typically demonstrates right ventricular dilatation, low pulmonary arterial pressure, dilated hepatic veins, and varying degrees of inferior wall injury.

Despite jugular distention, fluid loading that maintains right ventricular filling pressure is a key therapy in avoiding or treating hypotension. Avoid diuretics and vasodilators if possible. Maintenance of sinus rhythm and atrioventricular synchrony is important; and treat atrial fibrillation or atrioventricular block early.^[45]

Medication

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Claudia Dima, MD, FACC Interventional Cardiology

Disclosure: Nothing to disclose.

Coauthor(s)

David L Coven, MD, PhD Assistant Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons; Director, Cardiology Outpatient Clinic, St Luke’s Site, Attending Physician, Department of Medicine, Division of Cardiology, St Luke’s-Roosevelt Hospital Center

David L Coven, MD, PhD is a member of the following medical societies: American College of Physicians, American Medical Association, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Ashish Pershad, MD Consulting Staff, Heart and Vascular Center of Arizona

Ashish Pershad, MD is a member of the following medical societies: American College of Cardiology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Richard A Lange, MD, MBA President, Texas Tech University Health Sciences Center, Dean, Paul L Foster School of Medicine

Richard A Lange, MD, MBA is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American Heart Association, Association of Subspecialty Professors

Disclosure: Nothing to disclose.

Chief Editor

Eric H Yang, MD Associate Professor of Medicine, Director of Cardiac Catherization Laboratory and Interventional Cardiology, Mayo Clinic ArizonA

Eric H Yang, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Additional Contributors

Kenneth B Desser, MD  Former Clinical Professor, Director of Cardiology Fellowship, Banner Good Samaritan Medical Center

Disclosure: Nothing to disclose.

George A Stouffer, III, MD Ernest and Hazel Craige Distinguished Professor of Medicine and Cardiology, Chief of Cardiology, University of North Carolina Medical Center

George A Stouffer, III, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American College of Physicians, American Heart Association, Phi Beta Kappa, Society for Cardiovascular Angiography and Interventions

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the contributions of previous author Rex C Liu, MD, to the development and writing of the source article.

Leads	Sensitivity (%)	Specificity (%)
V₁	28	92
V₃ R	69	97
V₄ R	93	95

Right Ventricular Infarction Guidelines

Guidelines Summary

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