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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
Question 14 of 17:
The right coronary artery usually supplies most of the right ventricular myocardium.
You clicked 'True'
Correct!
The right coronary artery usually supplies most of the right ventricular myocardium. Hence the occlusion of the artery proximal to the right ventricular branches will lead to right ventricular ischemia (1).
Hemodynamically, significant right ventricular infarction occur almost exclusively in the setting of inferior wall acute myocardial infarction (2).Although right ventricular ischemia can be demonstrated in up to half of all inferior myocardial infarcts, although only 10 to 15% of patients show classical hemodynamic abnormalities (3,4).
Reference:
1. Weinshel AJ, Isner JM, Salem DN, Konstam MS. The coronary anatomy of right ventricular infarction: relationship between the site of right coronary artery occlusion and origin of the right ventricular free wall branches. Circulation 1983;68 (suppl III):III-351 (abstract).
2. Anderson HR, Falk E, Nielsen D. Right ventricular infarction: frequency, size and topography in coronary artery disease: a prospective study compromising 107 consecutive autopsies from a coronary care unit. J Am Coll Cardiol 1987;10:1223-1232.
3. Zehender M, Kasper W, Kauder E et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993;328:981-988.
4. Berger PB, Ryan TJ. Inferior myocardial infarction: high-risk subgroups. Circulation 1990;81:401-411.
Copyright 2001 by the University of Michigan Board of Regents. All rights reserved.