A clinical case of right ventricular myocardial infarction in a patient with diabetes mellitus and Fahr’s disease
- Authors: Yashin S.S.1, Isakova N.V.1, Anisimov S.O.1, Yevgrafova A.S.1
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Affiliations:
- Samara State Medical University
- Issue: Vol 42, No 2 (2025)
- Pages: 121-129
- Section: Clinical case
- URL: https://journals.rcsi.science/PMJ/article/view/294288
- DOI: https://doi.org/10.17816/pmj422121-129
- ID: 294288
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Abstract
Right ventricular myocardial infarction (RVMI) is quite a rare and difficult to diagnose disease. The leading method in the diagnosis of RVMI is a standard electrocardiography (ECG) in 12 leads, but a reliable establishment of this pathology is possible only with the use of mirror-image right precordial leads. In the presented clinical case, a 68-year-old patient was admitted to the hospital with complaints of weakness in the right extremities, speech impairment, nausea and vomiting. A complete examination was carried out and conservative treatment was initiated. Despite the treatment being administered, the patient's condition continued to deteriorate progressively, and therefore it was decided to transfer the patient to the intensive care unit, where an ECG revealed the likelihood of ischemia of the anterolateral and lower walls. The next day, respiratory and cardiac arrest was diagnosed, and resuscitation measures had no effect. During autopsy, cardiomyocyte necrosis zones with perifocal inflammation were found in the myocardium of the right ventricle, corresponding to myocardial infarction within 6 to 12 hours. Clinical observation emphasizes the importance of timely diagnosis of RVMI, especially against the background of severe metabolic disorders in the organism caused by diabetes mellitus.
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##article.viewOnOriginalSite##About the authors
S. S. Yashin
Samara State Medical University
Author for correspondence.
Email: s.s.yashin@samsmu.ru
ORCID iD: 0000-0002-0783-8709
SPIN-code: 4740-3280
Scopus Author ID: 57218915041
Senior Lecturer
Russian Federation, SamaraN. V. Isakova
Samara State Medical University
Email: s.s.yashin@samsmu.ru
ORCID iD: 0000-0001-8764-7955
SPIN-code: 2515-3947
PhD (Medicine), Associate Professor of the Department of General and Clinical Pathology
Russian Federation, SamaraS. O. Anisimov
Samara State Medical University
Email: s.s.yashin@samsmu.ru
ORCID iD: 0009-0007-7282-2416
Student of the Institute of Clinical Medicine
Russian Federation, SamaraA. S. Yevgrafova
Samara State Medical University
Email: s.s.yashin@samsmu.ru
ORCID iD: 0009-0005-7412-5062
Student of the Institute of Clinical Medicine
Russian Federation, SamaraReferences
- Mozaffarian D., Benjamin E.J., Go A.S. et al. American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016; 133 (4): e38–360. doi: 10.1161/CIR.0000000000000350
- Andersen H.R., Falk E., Nielsen D. Right ventricular infarction: frequency, size and topography in coronary heart disease: a prospective study comprising 107 consecutive autopsies from a coronary care unit. J. Am. Coll. Cardiol. 1987; 10 (6): 1223–1232. doi: 10.1016/s0735-1097(87)80122-5
- Starr I., Jeffers W.A., Meade R.H. The absence of conspicuous increments of venous pressure after severe damage to the right ventricle of the dog with a discussion of the relation between clinical congestive failure and heart disease. Am. Heart. J. 1943; 26: 291–301. doi: 10.1016/S0002-8703(43)90325-4
- Sanders A.O. Coronary thrombosis with complete heart-block and relative ventricular tachycardia a case report. Am. Heart. J. 1931; 6: 820–823.
- Cohn J.N., Guiha N.H., Broder M.I., Limas C.J. Right ventricular infarction. Clinical and hemodynamic features. Am. J. Cardiol. 1974; 33 (2): 209–214. doi: 10.1016/0002-9149(74)90276-8
- Kinch J.W., Ryan T.J. Right ventricular infarction. N. Engl. J. Med. 1994; 330 (17): 1211–1217. doi: 10.1056/NEJM199404283301707
- Dell'Italia L.J., Starling M.R., O'Rourke R.A. Physical examination for exclusion of hemodynamically important right ventricular infarction. Ann. Intern. Med. 1983; 99 (5): 608–611. doi: 10.7326/0003-4819-99-5-608
- Dell'Italia L.J., Starling M.R., Crawford M.H., Boros B.L., Chaudhuri T.K., O'Rourke R.A. Right ventricular infarction: identification by hemodynamic measurements before and after volume loading and correlation with noninvasive techniques. J. Am. Coll. Cardiol. 1984; 4 (5): 931–939. doi: 10.1016/s0735-1097(84)80053-4
- Cintron G.B., Hernandez E., Linares E., Aranda J.M. Bedside recognition, incidence and clinical course of right ventricular infarction. Am. J. Cardiol. 1981; 47 (2): 224–227. doi: 10.1016/0002-9149(81)90389-1
- Zehender M., Kasper W., Kauder E., Schönthaler M., Geibel A., Olschewski M., Just H. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N. Engl. J. Med. 1993; 328 (14): 981–988. doi: 10.1056/NEJM199304083281401
- Fijewski T.R., Pollack M.L., Chan T.C., Brady W.J. Electrocardiographic manifestations: right ventricular infarction. J. Emerg. Med. 2002; 22 (2): 189–194. doi: 10.1016/s0736-4679(01)00463-2
- Birnbaum Y., Sclarovsky S., Mager A., Strasberg B., Rechavia E. ST segment depression in aVL: a sensitive marker for acute inferior myocardial infarction. Eur. Heart J. 1993; 14 (1): 4–7. doi: 10.1093/eurheartj/14.1.4
- Saw J., Davies C., Fung A., Spinelli J.J., Jue J. Value of ST elevation in lead III greater than lead II in inferior wall acute myocardial infarction for predicting in-hospital mortality and diagnosing right ventricular infarction. Am. J. Cardiol. 2001; 87 (4): 448–450, A6. doi: 10.1016/s0002-9149(00)01401-6
- Яшин С.С., Юнусова Ю.Р., Исакова Н.В., Ларина Т.В., Михайлова Ю.В., Иванова Е.А., Елфимов И.В. Болезнь Фара у пациентки с острым нарушением мозгового кровообращения. Современные проблемы науки и образования 2020; (6): 188. doi: 10.17513/spno.30457 / Yashin S.S., Yunusova Yu.R., Isakova N.V., Larina T.V., Mikhailova Yu.V., Ivanova E.A., Elfimov I.V. Fahr's disease in a patient with acute cerebrovascular accident. Modern Problems of Science and Education 2020; (6): 188. doi: 10.17513/spno.30457 (in Russian).
- Carbone M.G., Della Rocca F. Neuropsychiatric manifestations of Fahr's disease, diagnostic and therapeutic challenge: A Case Report and a Literature Review. Clin Neuropsychiatry 2022; 19 (2): 121–131. doi: 10.36131/cnfioritieditore20220206
- Li Y., Liu Y., Liu S., Gao M., Wang W., Chen K., Huang L., Liu Y. Diabetic vascular diseases: molecular mechanisms and therapeutic strategies. Signal Transduct Target Ther. 2023; 8 (1): 152. doi: 10.1038/s41392-023-01400-z
- Басанцова Н.Ю., Шишкин А.Н., Тибекина Л.М. Цереброкардиальный синдром и его особенности у пациентов с острыми нарушениями мозгового кровообращения. Вестник Санкт-Петербургского университета. Медицина 2017; 12 (1): 31–47. / Basantsova N.Yu., Shishkin A.N., Tibekina L.M. Cerebrocardial syndrome and its features in patients with acute cerebrovascular accidents. Bulletin of St. Petersburg University. Medicine 2017; 12 (1): 31–47 (in Russian).
- Яшин С.С., Киреева А.О., Сухачев П.А. Стресс-индуцированная кардиомиопатия (синдром такоцубо). Инновационная медицина Кубани 2023; 8 (1): 111–115. / Yashin S.S., Kireeva A.O., Sukhachev P.A. Stress-induced cardiomyopathy (takotsubo syndrome). Innovative Medicine of Kuban 2023; 8 (1): 111–115 (in Russian).
- Слатова Л.Н., Федорина Т.А., Бормотов А.В., Самычин М.Ю., Буклешева И.М. Морфологическая характеристика атеросклеротических бляшек коронарных и сонных артерий у пациентов с инфарктом миокарда. Наука и инновации в медицине 2017; 2 (6): 15–19. / Slatova L.N., Fedorina T.A., Bormotov A.V., Samychin M.Yu., Buklesheva I.M. Morphological characteristics of coronary and carotid atherosclerotic plaques in patients with myocardial infarction. Science and Innovations in Medicine 2017; 2 (6): 15–19 (in Russian).
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