ISOLATED ACUTE OCCLUSION OF A LARGE RIGHT-VENTRICULAR BRANCH OF THE RIGHT CORONARY-ARTERY FOLLOWING CORONARY BALLOON ANGIOPLASTY - THE ONLYTRUE MODEL TO STUDY ECG-CHANGES IN ACUTE, ISOLATED RIGHT-VENTRICULAR INFARCTION

An isolated right ventricular infarction occurs rarely and data on its electrocardiographic appearance and underlying angiographically prove n cause are scarce. The electrocardiographic response of acute right v entricular ischaemia is often obscured by the coexisting forces of the ischaemic mass of the inferior wall of the left ventricle when the ri ght coronary artery itself becomes occluded. Percutaneous transluminal coronary angioplasty of the right coronary artery may cause an isolat ed occlusion of a right ventricular branch. We encountered this phenom enon in nine patients. In all, it led to acute isolated right ventricu lar ischaemia with ST elevations in the right precordial leads (V-1-V- 3, V(3)R and V(4)R) on the electrocardiogram. We conclude that the ECG pattern of pure right ventricular ischaemia can be seen when an isola ted occlusion of a large right ventricular branch occurs, for example as a complication of percutaneous transluminal coronary angioplasty.