| Abstrakt: |
Aim: The aim of the present study was to evaluate ST elevation myocardial infarction of inferior wall and right ventricle in rheumatic mitral stenosis due to thrombus at right coronary sinus. Methods: The present study was conducted in the Department of cardiology, Burdwan medical college and hospital, West Bengal, India. Acute MI was diagnosed by the presence of at least 2 of the following criteria: electrocardiographic changes, significant rises in myocardial bound creatine kinase fraction, and typical chest pain. Inferior wall MI was diagnosed by electrocardiography, echocardiography and coronary angiography. In patients with non-ST elevation MI, echocardiography and coronary angiographic findings were used for determination of the diagnosis of inferior wall MI. There was total 100 patients included in the present study. Results: Echocardiography was performed within 1.7±1.4 days (range 0-5) after acute MI. There were no differences in age, sex and other frequencies of underlying diseases among the 3 groups. There were no differences in the modality of intervention, severity of coronary artery disease. Fifty-five (73.34%) patients had the culprit lesion in the right coronary artery and 20 (26.6%) patients had the culprit lesion in the left circumflex artery. Patients whose culprit lesion in the left circumflex artery had an increased frequency of more severe MR than those with the culprit lesion in the right coronary artery, but this difference did not reach statistical significance (P=0.420). Conclusion: In the acute phase of inferior wall MI, MR was associated with LV systolic dysfunction with tethering. Therefore, it can be suggested that reduced closing force as a consequence of LV systolic dysfunction in the presence of leaflet tethering would play a more pivotal role in the development of MR in the acute phase of inferior MI, whereas increased tethering forces through a combination of annular dilation and geometric remodeling of the LV would be more important contributor in the chronic phase. [ABSTRACT FROM AUTHOR] |
