Disturbance of Pulmonary Gas Exchange in Patients with Right Ventricular

To evaluate the difference in pulmonary gas exchange in patients with and without right ventricular infarction, 147 consecutive patients with their first inferior wall Q-wave acute myocardial infarction were studied. Thirty-nine patients (group 1) had electrocardiographic evidence of right ventricular infarction and it was absent in 108 patients (group 2). A significantly wider alveolar arterial oxygen difference and higher roentgenographic scores were ohserved in group 1 compared with group 2. Although there were na significant differences in pulmonary artery wedge pressure and colloid osmotic pressure between groups 1 and 2, mean right atrial pressure was significantly higher, rterial hypoxemia with pulmonary congestion is often recognized during the early phase of acute myocardial infarction. ‘� Although the advances in noninvasive cardiac diagnosis have increased the awareness of right ventricular infarction and characteristic hemodynamic pattern has been well-established,�� not many studies have focused on pulmonary gas exchange and chest roentgenographic manifestalion in patients with right ventricular infarction. Because hydrostatic pressure and vascular permeability are reported to be some of the mechanisms associated with the development of pulmonary edema,’�’� we hypothesized that hemodynamic impairment, colloid osmotic pressure, myocardial infarct size, age, and the presence ofright ventricular infarclion may affect pulmonary gas exchange in patients with inferior infarction. Therefore, the purpose of this study was to evaluate the difference in pulmonary gas exchange between patients with and without right ventricular infarction following their first inferior wall Q-wave myocardial infarction.