Underlying cardiomyopathy in patients with ST-segment elevation in the right precordial leads.
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.
Kim
Hyungseop
H
Division of Cardiology, Department of Internal Medicine, Kyungpook National University, Taegu, Korea.
Cho
Yongkeun
Y
Park
Yonghwi
Y
Lee
Hyunsang
H
Kang
Hyunjae
H
Nah
Deuk-Young
DY
Park
Taein
T
Yang
Dong Heon
DH
Park
Hun Sik
HS
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
D026941:Sodium Channel Blockers