Right-ventricular infarction.

Taletha Carter is a clinical nurse specialist in the cardiac step-down units at the Cleveland Clinic Foundation, Cleveland, Ohio. She has 15 years of experience in nursing, with a concentration in critical care. Keith Ellis completed his cardiology fellowship at the Cleveland Clinic Foundation, Cleveland, Ohio. He completed his interventional cardiology fellowship at the University of Texas Health Sciences Center in Houston and is affiliated with Diagnostic Cardiology of Houston. The signs and symptoms of RVI are similar to those of left ventricular infarction. Less than 50% of patients have hemodynamic compromise. RVI is difficult to diagnose because the prognosis is determined largely by the extent of left ventricular involvement. The right ventricle recovers much of its function during the months after the myocardial infarction, usually returning to its baseline level of function. Patients with minimal involvement of the left ventricle have an excellent long-term prognosis. Early recognition of RVI is critical for reducing mortality and complications associated with this cardiac injury. Inferior myocardial infarction with RVI has a high mortality rate of 25% to 30% as compared with only 6% for inferior infarctions not involving the right ventricle. Volume resuscitation and reperfusion therapy should be started early. In this article, we discuss the pathophysiology, clinical features, diagnosis, treatment, and complications associated with RVI.