Underlying Cardiomyopathy in Patients With ST-Segment Elevation in the Right Precordial Leads

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  • Kim Hyungseop
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University
  • Cho Yongkeun
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University
  • Park Yonghwi
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University
  • Lee Hyunsang
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University
  • Kang Hyunjae
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University
  • Nah Deuk-Young
    Division of Cardiology, Department of Internal Medicine, Dongguk University
  • Park Taein
    Department of Pathology, Kyungpook National University
  • Yang Dong Heon
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University
  • Park Hun Sik
    Division of Cardiology, Department of Internal Medicine, Kyungpook National University

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Abstract

Background Ventricular fibrillation (VF) and sudden death (SD) may occur in patients with ST-segment elevation in the right precordial leads. The mechanism of such events is unclear, so the aim of the present study was to assess whether there is an underlying morphological or pathological abnormality in these patients. Methods and Results Fourteen consecutive patients (44±10 years old, all male) with ST-segment elevation of more than 2 mm in the right precordial leads underwent a cardiac evaluation, including right ventriculography and endomyocardial biopsy. The ST-segment changes after the administration of sodium-channel blockers were also evaluated. Two patients survived documented VF, 11 patients had chest pain or tightness, and another patient had a history of syncope. Only 1 patient had a family history of premature SD. The coronary angiograms were normal in all the patients. VF was induced in 5 patients (36%). Wall motion abnormalities of the right ventricle were detected in 4 patients (29%) and endomyocardial biopsy revealed features of cardiomyopathy in 7 patients (50%). In total, 9 (64%) of 14 patients exhibited wall motion abnormalities and/or pathologic findings. Conclusions Underlying cardiomyopathy was present in more than half of the present patients with ST-segment elevation in the right precordial leads. (Circ J 2006; 70: 719 - 725)<br>

Journal

  • Circulation Journal

    Circulation Journal 70 (6), 719-725, 2006

    The Japanese Circulation Society

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