title: Underlying cardiomyopathy in patients with ST-segment elevation in the right precordial leads.
abstract: BACKGROUND
  Ventricular fibrillation (VF) and sudden death (SD) may occur in patients with ST-segment elevation in the right precordial leads. The mechanism of such events is unclear, so the aim of the present study was to assess whether there is an underlying morphological or pathological abnormality in these patients.
  
  
  RESULTS
  Fourteen consecutive patients (44+/-10 years old, all male) with ST-segment elevation of more than 2 mm in the right precordial leads underwent a cardiac evaluation, including right ventriculography and endomyocardial biopsy. The ST-segment changes after the administration of sodium-channel blockers were also evaluated. Two patients survived documented VF, 11 patients had chest pain or tightness, and another patient had a history of syncope. Only 1 patient had a family history of premature SD. The coronary angiograms were normal in all the patients. VF was induced in 5 patients (36%). Wall motion abnormalities of the right ventricle were detected in 4 patients (29%) and endomyocardial biopsy revealed features of cardiomyopathy in 7 patients (50%). In total, 9 (64%) of 14 patients exhibited wall motion abnormalities and/or pathologic findings.
  
  
  CONCLUSIONS
  Underlying cardiomyopathy was present in more than half of the present patients with ST-segment elevation in the right precordial leads.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kyungpook National University, Taegu, Korea.
authors.forename: Hyungseop
authors.initials: H
authors.lastname: Kim
authors.forename: Yongkeun
authors.initials: Y
authors.lastname: Cho
authors.forename: Yonghwi
authors.initials: Y
authors.lastname: Park
authors.forename: Hyunsang
authors.initials: H
authors.lastname: Lee
authors.forename: Hyunjae
authors.initials: H
authors.lastname: Kang
authors.forename: Deuk-Young
authors.initials: DY
authors.lastname: Nah
authors.forename: Taein
authors.initials: T
authors.lastname: Park
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Yang
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
mesh_terms: D000328:Adult; D001706:Biopsy; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D017023:Coronary Angiography; D003645:Death, Sudden / Q000473:pathology; D004452:Echocardiography; D004562:Electrocardiography; D006321:Heart / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D026941:Sodium Channel Blockers / Q000008:administration & dosage; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology
chemical_list: D026941:Sodium Channel Blockers