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Japanese

A case report of right ventricular infarction clearly detected by transesophageal echocardiography Yuhji Furutani 1 , Hirosi Ogawa 1 , Zenzou Fujii 1 , Takasi Fujii 1 , Masunori Matsuzaki 1 , Yasuo Matsuda 1 , Reizou Kusukawa 1 1The Second Department of Internal Medicine, Yamaguchi University, School of Medicine Keyword: 右室梗塞(right ventricular infarction) , 食道心エコー(transesophageal echocardiogrphy) , 心原性ショック(cardiogenic shock) pp.1149-1152
Published Date 1990/11/15
DOI https://doi.org/10.11477/mf.1404910051
  • Abstract
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We reported a case of a 70 year-old woman who suffered from right ventricular infarction with car-diogenic shock, detected clearly by transesophageal echocardiography.

On admission, her pulse rate was 31 bpm and her blood pressure was unobtainable. Conscious level was III-1~2 and she was cold and clamy. The ECG showed complete AV block with junctional escape rhythm at a rate of 31 bpm which required tem-porary pacing and ST elevation in leads II, III, aVF, V4R, V3R, V1. An echocardiogram showed akinesis of RV free wall and paradoxical septal motion. Transesophageal echocardiography was performed safely on the 5th hospital day and detected RV wall motion abnormality clearly. A Swan-Ganz catherter was inserted. Mean PCW was 12mmHg. PA pres-sure was 19/11mmHg. Mean RA pressure was 13mmHg. Cardiac index was 1.33 1/min/m2. SvO2 was 54%. Volume loading, administration of dopamine, dobutamine and nitroprusside were started. Cardiac index increased to 1.88l/min/m2, and SvO2 increased to 59%. On the 4th hospital day, mean RA pressure increased to 29 mmHg and PA pressure increased to 47/31mmHg acutely. Endotracheal intubation was done and PEEP 6cmH2O was used and mean RA pressure and PA pressure decreased. On the 6th hospital day, cardiac index increased 4.08l/min/m2. Cardiac catheterizationn done two months after acute myocardial infarction showed 75% stenosis of the proximal right coronary artery.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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