Right Ventricular Infarction in Acute Inferior Myocardial Infarction: A Study of Clinical Course and Mortality at Rajshahi Medical College Hospital

Abstract

Background: Right ventricular infarction (RVI) frequently complicates acute inferior myocardial infarction (AIMI) and is associated with increased morbidity and mortality. This prospective cohort study aimed to determine the prevalence of RVI in patients with AIMI and assess its impact on in-hospital outcomes. Methods: A total of 120 patients admitted with AIMI to the coronary care unit of Rajshahi Medical College Hospital (RMCH) were enrolled over twelve months following ethical approval. RVI was assessed using a 12-lead ECG. Patients were divided into two groups based on the presence (Group A) or absence (Group B) of RVI. Demographic, clinical, and biochemical data were recorded, and in-hospital complications were compared between groups. Result: RVI was identified in 31.7% of AIMI patients. Patients with RVI exhibited significantly lower systolic (96.8±4.7 vs 119.5±4.8 mmHg) and diastolic blood pressure (66.6±3.3 vs 78.3±2.4 mmHg) and lower heart rates (82.5± 7.4 vs 89.9± 6.4 bpm) compared to those with AIMI alone (p<0.05). Troponin-I levels were significantly lower in group A (0.99±0.1 vs 4.06±1.4 ng/mL, p<0.001). Complications such as cardiogenic shock (44.7% vs 18.3%) and atrioventricular blocks (21.1% vs 3.7%) were significantly more frequent in the RVI group (p<0.05). The mean duration of hospital stay was significantly shorter in Group A (p<0.05). In-hospital mortality was substantially higher among RVI patients (23.7% vs 3.7%, p<0.05). Multivariate logistic regression identified RVI as a significant independent predictor of in-hospital mortality (OR=15.87, p=0.001). Conclusion: This study demonstrates that RVI is a common and significant determinant of adverse in-hospital outcomes in patients with AIMI at RMCH. Prompt recognition and management of RVI are crucial to reducing morbidity and mortality in this vulnerable population.