孤立性右心室梗死——揭开伪装者的面纱。

Isolated right ventricular infarction - Unmasking the masquerader.

作者信息

Manandhar Srista, Chhetri Sunit, Tannenbaum Jordan, Alvarez Manrique, Pokharel Yashashwi

机构信息

Department of Cardiovascular Medicine, Atrium Health Wake Forest Baptist, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

出版信息

J Cardiol Cases. 2025 May 1;32(1):36-38. doi: 10.1016/j.jccase.2025.04.005. eCollection 2025 Jul.

DOI:10.1016/j.jccase.2025.04.005

PMID:40697206

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12277591/

Abstract

UNLABELLED

Right ventricular (RV) infarction is commonly associated with left ventricular (LV) myocardial infarction. Isolated RV infarction is a rare entity and the diagnosis is challenging. We present a case of a 65-year-old man with non-ST elevation myocardial infarction without obvious culprit obstructive coronary artery disease on coronary angiogram. There was late gadolinium enhancement (LGE) of RV free wall without LGE of the LV in magnetic resonance imaging (MRI) which helped in diagnosing isolated RV infarction. On follow up, the patient's RV dysfunction normalized on echocardiogram. Our case shows the importance of cardiac MRI in the diagnosis of isolated RV infarction and that it can have a good prognosis.

LEARNING OBJECTIVES

Diagnosis of isolated right ventricular (RV) infarction needs high degree of suspicion especially in absence of hemodynamic findings. Late gadolinium enhancement in cardiac magnetic resonance imaging can help diagnose RV infarction when there is diagnostic uncertainty. Early therapy helps in RV recovery.

摘要

未标注

右心室（RV）梗死通常与左心室（LV）心肌梗死相关。孤立性右心室梗死是一种罕见情况，诊断具有挑战性。我们报告一例65岁男性，患有非ST段抬高型心肌梗死，冠状动脉造影未发现明显的罪犯阻塞性冠状动脉疾病。磁共振成像（MRI）显示右心室游离壁晚期钆增强（LGE），而左心室无LGE，这有助于诊断孤立性右心室梗死。随访时，患者的右心室功能障碍在超声心动图上恢复正常。我们的病例显示了心脏MRI在孤立性右心室梗死诊断中的重要性，且其预后良好。