Case 2:

63-year old woman presented with central chest pain of two hours duration. On examination her blood pressure was 90/60 mm Hg, she had a weak pulse, distended neck veins with elevated jugular venous pressure, normal first and second heart sounds and lung fields were clear on auscultation.

Ragavendra R. Baliga, M.D
Assistant Professor
Division of Cardiology
University Of Michigan

 

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Question 5 of 17:

When there are non-diagnostic findings echocardiography can be helpful in making the diagnosis of right ventricular ischemia.

You clicked 'False'

Incorrect!

Echocardiography can be helpful in patients with suspicious but non diagnostic findings. It can show right ventricular dilatation and asynergy, abnormal interventricular and interatrial septal motion and even right to left shunting through a patent formane ovale (1-3). This is shunting is unique to right ventricular ischemia and should be suspected when persistent hypoxia is not responsive to supplemental oxygen (1).

 

References:

1. Sharkey SW, Shelley W, Carlyle PF, Rysavy J, Cohn JN. M-mode and two-dimensional echocardiographic analysis of the septum in experimental right ventricular infarction: correlation with hemodynamic alterations. Am Heart J 1985;110:1210-1218.

2. Lopez-Sendon J, Lopez de Sa E, Roladan I, Fernandez de Soria R, Ramos F, Martin Jadraque L. Inversion of the normal interatrial septum convexity in acute myocardial infarction: incidence, clinical relevance and prognostic significance. J Am Coll Cardiol 1990;15:801-805.

3. Manno BV, Bemis CE, Carver J, Mintz GS. Right ventricular infarction complicated by right to left shunt. J Am Coll Cardiol 1983;1:554-557.

 
 
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