Right ventricular involvement in patients with coronary artery disease
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PURPOSE OF REVIEW: RV involvement in coronary artery disease (CAD) includes isolated infarction and involvement in left ventricular infarction. Right ventricular involvement with left ventricular infarction has unique clinical signs and symptoms, requires different management, and has worse prognosis than left ventricular infarcts without right ventricular involvement. Although the right ventricle (RV) is geometrically complex, advances in echocardiography, nuclear imaging, computed tomography, and magnetic resonance imaging technologies have helped to optimally visualize its structure and function and to better elucidate its role in CAD. RECENT FINDINGS: Newer noninvasive imaging modalities to visualize the RV are highlighted and their emerging clinical utilities are emphasized, including three-dimensional echocardiography, tissue Doppler velocity and strain imaging, computed tomography, and MRI. SUMMARY: The RV is often involved in CAD. Available imaging modalities demonstrate different aspects of right ventricular involvement, yielding new insights into pathophysiology, clinical care, and management. As imaging technologies widen in their scope, cardiologists will increasingly have the imaging tools to integrate information on right ventricular morphology, hemodynamics, and function, enabling appropriate care for patients with right ventricular involvement in CAD.
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