Differences between left and right ventricular myocardial infarction

	Left ventricular MI	Right ventricular MI
Clinical features	Pulmonary congestion	Clear lung fields
	Third and fourth heart sounds	Right-sided third heart sound
	New mitral regurgitation	New tricuspid regurgitation
		Hypotension with distended neck veins
Electrocardiogram	ST elevation in standard leads	ST elevation in V4R
		Commonly associated with inferior MI
		Frequent atrioventricular block
Hemodynamic findings	Increased pulmonary capillary wedge pressure (PCWP)	Right atrial pressure (RAP) ≥10 mmHg
Hemodynamic findings		RAP:PCWP ≥0.8
Specific management	Fluid restriction	Fluid resuscitation
	Preload and afterload reduction	Avoid preload reduction
	Reperfusion therapy	Reperfusion therapy
	Inotropic agents, if necessary	Inotropic agents, if necessary

Left_vs_right_ventricular_M.htm

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