孤立性右心室梗死-揭开伪装者的面纱

Q4 Medicine

Journal of Cardiology Cases Pub Date : 2025-07-01 DOI:10.1016/j.jccase.2025.04.005

Srista Manandhar MBBS, Sunit Chhetri MBBS, Jordan Tannenbaum MD, Manrique Alvarez MD, Yashashwi Pokharel MD, MSCR

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引用次数: 0

摘要

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的实体，诊断具有挑战性。我们报告一例65岁男性非st段抬高型心肌梗死，冠状动脉造影无明显的罪魁祸首阻塞性冠状动脉疾病。磁共振成像（MRI）显示左室游离壁晚期钆增强（LGE），但无左室的LGE，有助于诊断孤立性左室梗死。随访中，超声心动图显示患者右心室功能障碍恢复正常。我们的病例显示了心脏MRI在诊断孤立性右心室梗死中的重要性，它可以有良好的预后。学习目的孤立性右心室（RV）梗死的诊断需要高度的怀疑，特别是在没有血流动力学结果的情况下。在诊断不确定的情况下，心脏磁共振成像晚期钆增强有助于诊断右室梗死。早期治疗有助于RV恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Isolated right ventricular infarction – Unmasking the masquerader

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.

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