Microvascular obstruction complicating acute right ventricular myocardial infarction

J Cardiovasc Med (Hagerstown). 2015 Jan:16 Suppl 1:S12-4. doi: 10.2459/JCM.0b013e32835fa815.

Abstract

This case history describes a man with inferior myocardial infarction (MI) with right-ventricular involvement, treated with a right coronary artery stent. Magnetic resonance showed akinesia of left-ventricular inferior and inferolateral walls and right-ventricular inferior free wall with an impairment of global systolic function. There was late gadolinium enhancement (LGE) of left-ventricular inferior and inferolateral walls with microvascular obstruction (MVO). LGE of the right-ventricular inferior wall was seen with a hypointense core within hyperenhanced myocardium, consistent with MVO of the infarcted right-ventricular myocardium. At follow-up there was persistent akinesia of left-ventricular inferior and inferolateral walls and right-ventricular systolic dysfunction. LGE was still evident with resolution of MVO.

Publication types

  • Case Reports

MeSH terms

  • Contrast Media
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / pathology
  • Gadolinium
  • Heart Ventricles / pathology*
  • Humans
  • Inferior Wall Myocardial Infarction / pathology*
  • Inferior Wall Myocardial Infarction / therapy
  • Magnetic Resonance Angiography*
  • Male
  • Microvessels / diagnostic imaging
  • Microvessels / pathology*
  • Middle Aged
  • Percutaneous Coronary Intervention / methods
  • Radiography
  • Stents
  • Ventricular Function*

Substances

  • Contrast Media
  • Gadolinium