Right Ventricular Infarction Guidelines

Updated: Mar 29, 2017
  • Author: Claudia Dima, MD, FACC; Chief Editor: Eric H Yang, MD  more...
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Guidelines

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]