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Extreme Right Axis Deviation in Acute Myocardial Infarction: A Hazardous Signal of Poor Prognosis
- Source :
- The American Journal of Case Reports
- Publication Year :
- 2018
- Publisher :
- International Scientific Information, Inc., 2018.
-
Abstract
- Patient: Male, 72 Final Diagnosis: Acute myocardial infarction Symptoms: — Medication: Cardiac catheterization Clinical Procedure: — Specialty: Cardiology Objective: Unusual clinical course Background: New-onset extreme right axis deviation and right bundle branch block (RBBB) are rare during acute myocardial infarction (AMI), and has only been reported in several cases reflecting the severity of AMI. It could predict severe clinical complications and higher risks in coronary artery disease. Although there is little electrophysiological explanation, the complications are severe. They should be emphasized in newly diagnosed extreme right axis deviation and RBBB in AMI. Case Report: A 72-year-old male was admitted to our department with a chief complaint of intermittent retrosternal chest pain and was diagnosed with extensive anterior myocardial infarction with RBBB, by elevated myocardial enzymes and ECG. The main wave direction of QRS in lead aVR was positive and showed an extreme right axis deviation. After a month, the patient’s chest distress and the RBBB vanished, but a right axis deviation still existed. The echocardiogram showed prior extensive anterior myocardial infarction (including apex myocardia) and lower LVEF. Conclusions: New diagnosed RBBB and right axis deviation is uncommon and could be a useful clue to evaluate myocardial ischemia in AMI cases. This electrocardiographic marker can identify coronary artery occlusion where ST-segments are hard to evaluate, and hence, patients may benefit most from early and complete revascularization strategies such as primary angioplasty.
- Subjects :
- Male
medicine.medical_specialty
Bundle-Branch Block
Myocardial Infarction
030204 cardiovascular system & hematology
Coronary artery disease
Electrocardiography
03 medical and health sciences
QRS complex
0302 clinical medicine
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Anterior Wall Myocardial Infarction
Aged
business.industry
Troponin I
Stroke Volume
Articles
General Medicine
Extreme Right Axis Deviation
Right bundle branch block
Prognosis
medicine.disease
Echocardiography
Cardiology
Myocardial infarction diagnosis
Axis
Right axis deviation
business
Subjects
Details
- ISSN :
- 19415923
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- American Journal of Case Reports
- Accession number :
- edsair.doi.dedup.....7500bc80430762b3be022b47c471718f