S.D. MAYANSKAYA¹, A.A. GILMANOV², T.V. RUDNEVA², M.M. MANGUSHEVA¹, EWANG SUBE SIMON¹, A.A. KHARISOVA¹, A.F. USMANOVA¹

 ¹Kazan State Medical University, Kazan

²Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan

Contact details:

Mayanskaya S.D. — MD, Professor of the Department of Hospital Therapy

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-905-316-99-66, e-mail: Smayanskaya@mail.ru

 The article presents a clinical observation of myocardial infarction (MI) of the inferior wall of the left ventricle (LV) with ST-segment elevation in combination with damage to the right ventricle (RV). Unfortunately, there is often a delay in the timely diagnosis of RV involvement in the process. This is because, at the beginning of the symptoms, it may not differ clinically from the typical manifestations of MI of the inferior-diaphragmatic region of the LV. However, the combination of LV inferior wall MI with RV MI is an important, negative predictor of increased mortality in these patients. In this case, RV MI was diagnosed after stenting of the right coronary artery, only when signs of hypotension and increased pressure of the jugular veins appeared. Based on the analysis of this clinical case, the authors discuss the need to record an ECG of the right heart in most patients with inferior MI, especially in the presence of hypotension without signs of acute left ventricular failure.

Key words: myocardial infarction of the inferior wall of the left ventricle, myocardial infarction of the right ventricle, hypotension.

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