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European Heart Journal 1980 1(5):369-374;
Copyright © 1980 by the European Society of Cardiology.
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© 1980 The European Society of Cardiology

Pure right ventricular infarction

C.J.F.M. MIDDELHOFF, W. BÜTHKER* and A.E. BECKER

Department of Pathology, Wilhelmina Gasthuis, University of Amsterdam Amsterdam
* Department of Cardiology, Ziekenhtuis de Heel Zaandam, The Netherlands

Received 12 May 1980; .

Requests for reprints to: Prof. Dr A. E. Becker, Department of Pathology, Wilhelmina Gasthuis, Eerste Helmersstraat 104, 1054 EG Amsterdam, The Netherlands

The case is reported of a patient with chronic emphysema and cor pulmonale who developed the signs of acute myocardial infarction which were initially interpreted as being localized in the postero-inferior wall of the left ventricle. The patient rapidly developed the features of massive right heart failure in the absence of pulmonary congestion, a condition thought to be due to pulmonary emboli. The autopsy, however, revealed a pure right ventricular infarct, which covered more than half of the pre-existent right ventricular myocardium, in the setting of marked right ventricular hypertrophy infraction. The case furthermore shows that the possibility of pure right ventricular infarction should be evaluated in all patients with puzzling right heart failure, in the course of what initially is thought to be an acute left ventricular infraction, is important since therapy with plasma volume expanders should be used with great caution in such patients

Key Words: Right heart failure • right ventricular hypertrophy • cor pulmonale


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