Ginghina C. Mic tratat de cardiologie. Romania: Editura Academiei Romane; Greyson CR. The right ventricle and pulmonary circulation: basic concepts. the Romanian Journal of Cardiology and I are looking forward to your comments and suggestions! Kindest regards, Professor Carmen Ginghina Editor in chief. Eduard Apetrei. “CC Iliescu” Department of Cardiology – A short history. Cardiologie, cazuri comentate si Ilustrate, Eduard Apetrei, Carmen Ginghina.

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Sometimes arrhythmias are also present extra systoles, atrial fibrillation. Symptoms unilateral lower limb pain at palpation or unilateral oedema.

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In almost one third of the patients with both conditions, the electrocardiogram is within normal limits. The other laboratory tests such as slightly raised ESR; moderate leucocytosis; raised plasma fibrinogen; raised hematocrit; global hypercoagulative status in the first 48 h from the onset are not specific neither for RVMI nor for PE. A normal oxygen pressure does not exclude a PE. Wells Score [ 2 ]. Myocardial scintigraphy is rarely used at the onset of a myocardial infarction due to difficulties in mobilisation of the patient.

In PE ECG, changes are frequently non—specific and transient and they are less prominent when haemodynamic status is corrected.

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Echocardiography in the Management of Pulmonary Embolism. Acquired right ventricular dysfunction. In PE, both the sensitivity and ginhina of magnetic resonance imaging are lower when this method is compared with angio—CT scan to detect the pulmonary artery thrombi. In RVMI, the arterial blood gases can be normal but in massive infarction secondary hypoxemia, they can be present due to low cardiac output.


Indreptar de diagnostic si tratament in infarctul miocardic acut. An increased awareness must be kept in mind when we are using these elements because, very often they can be masked by volume depletion and the specific signs are usually obvious only after correcting the fluid status.

The necrotic area ginghima evidentiated as a result of myocardial concentration of the radiolabeled drug at cardiollgie level. Sechtem U, Mahrholdt H.

Received Apr 19; Accepted Jun Diagnostic value of D—dimer measurement in patients referred to the emergency department with suspected myocardial ischemia. However, this has low specificity when an anterior left ventricular myocardial infarction is not excluded. Guidelines on the diagnosis and management of acute pulmonary embolism. Electrocardiography in a case of inferoposterior and right ventricular myocardial infarction: Right bundle branch block or transient incomplete right bundle branch block.

ECG diagnosis criteria for pulmonary embolism modified from Chou [ 21 ]. Magnetic resonance imaging can rapidly identify within 1 hour those changes present in an acute myocardial infarction, and, it is the only method that can really differentiate between subendocardial and the transmural infarction.

Ed Academiei Romane ; A reliable marker for the right ventricular function is TAPSE tricuspid annular plane systolic excursion as it evaluates the longitudinal cardiac function. Electrocardiography in Clinical Practice. In other cases, alveolar haemorrhages can be present with a consolidation—like appearance or an oedema —like aspect.

Tissue Doppler echocardiography can also demonstrate ventricular asynchrony by ginhina septal and left ventricular free wall measurements.

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More frequently transient systolic dysfunction and reversible myocardial stunning are seen and most of cardioologie cases are recovering the right ventricular function in time. X—ray changes where pulmonary infarction is associated distal site periferic shadow more often in the shape of a triangle small pleural effusion on the same side elevated diaphragm on the same side.


They are usually associated with inferior and posterior left ventricle wall dyskinesia. Journal List J Med Life v. Additional laboratory tests can be requested in young patients with RVMI or PE in order to establish their coagulation status.

Chest CT scan using contrast substance is showing a filling gap at the level of left branch of pulmonary artery consistent with pulmonary thrombembolism. In conclusion, the clinician is expected to use the available methods wisely in order to make a differential diagnosis between the right ventricle myocardial infarction and PE, with a thorough approach to details, but in the same time, considering the whole clinical picture.

Table 1 Clinical symptoms and signs described in pulmonary embolism [ 2 ]. It is frequently recognized in medical literature as well as in daily clinical practice that right ventricular myocardial infarction and pulmonary gjnghina are two of the most challenging clinical pictures to differentiate in cardiology and the treatment, often chosen upon a mixture of clinical suspicion criteria subsequently confirmed by other diagnostic methods, can lead to therapeutic success.

This method is particularly useful in RVMI cases.