Right ventricular myocardial infarction: Clinical aspects

The clinical diagnosis of right ventricular myocardial infarction may be established by various techniques. These include physical examination, electrocardiogram, cardiac ultrasound, nuclear scintigraphy, and invasive hemodynamic evaluation. Each of these methodologies is complicated by potential pitfalls; as a result, the specificity and sensitivity of each technique vary considerably. In terms of specificity, however, hemodynamic findings constitute what is clearly the superior diagnostic test for right ventricular myocardial infarction and, accordingly, should be considered the clinical gold standard for the diagnosis of right ventricular myocardial infarction. Consequently, the most credible of published reports involving right ventricular myocardial infarction are those in which the diagnosis of right ventricular myocardial infarction has been confirmed by necropsy or hemodynamic data.