Comparison of left ventricular & right ventricular myocardial infarction

Left ventricular MI

Right ventricular MI

Clinical features

• Pulmonary edema
• S3 & S4

• Clear lungs & JVD
• Marked hypotension

ECG findings

• Ischemic changes in anterior, lateral, or inferior leads

• Inferior ischemic changes
• ST-segment elevation in V₄R
• Bradyarrhythmias

Hemodynamic findings

• ↑ LV & RV preload
• ↑ SVR

• ↑ RV preload, ↓ LV preload
• ↑ SVR

Management

• Fluid restriction
• Preload & afterload reduction
• Reperfusion therapy

• Fluid resuscitation
• Avoid preload reduction
• Reperfusion therapy

JVD = jugular venous distension; LV = left ventricular; MI = myocardial infarction; RV = right ventricular; SVR = systemic vascular resistance.