title: Isolated right ventricular infarction: a diagnostic challenge.
abstract: A 73-year-old woman was admitted to the emergency room due to sudden-onset dyspnoea, altered mental status and haemodynamic instability. ECG showed a junctional rhythm, T-wave inversion in I, aVL and V2-V6 (present in a previous ECG), and no ST/T changes in the right precordial leads. Transthoracic echocardiography, however, revealed a severe depression of global systolic function of right ventricle with akinesia of free wall and a normal left ventricular function. Coronary angiography showed an occlusion of the proximal segment of the right coronary artery, which was treated with balloon angioplasty, and a chronic lesion of the anterior descending artery. The patient had a good recovery and was discharged on the 14th day. Myocardial perfusion scintigraphy (stress and rest) was performed a month later, showing a fixed perfusion defect in the apex and anterior wall (medium-apical), with no signs of ischaemia.
authors.affiliation: Department of Cardiology, Braga Hospital, Braga, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Vieira
authors.affiliation: Department of Internal Medicine, Braga Hospital, Braga, Portugal Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.
authors.forename: Andre
authors.initials: A
authors.lastname: Santa Cruz
authors.affiliation: Department of Cardiology, Braga Hospital, Braga, Portugal.
authors.forename: Carina
authors.initials: C
authors.lastname: Arantes
authors.affiliation: Department of Cardiology, Braga Hospital, Braga, Portugal.
authors.forename: Sérgia
authors.initials: S
authors.lastname: Rocha
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome