Underlying Cardiomyopathy in Patients With ST-Segment
Elevation in the Right Precordial Leads
- Alternative Author(s)
- Kim, Hyung Seop
- Publication Year
- Background Ventricular fibrillation (VF) and sudden death (SD) may occur in patients with ST-segment elevation
in the right precordial leads. The mechanism of such events is unclear, so the aim of the present study was
to assess whether there is an underlying morphological or pathological abnormality in these patients.
Methods and Results Fourteen consecutive patients (44±10 years old, all male) with ST-segment elevation of
more than 2 mm in the right precordial leads underwent a cardiac evaluation, including right ventriculography
and endomyocardial biopsy. The ST-segment changes after the administration of sodium-channel blockers were
also evaluated. Two patients survived documented VF, 11 patients had chest pain or tightness, and another
patient had a history of syncope. Only 1 patient had a family history of premature SD. The coronary angiograms
were normal in all the patients. VF was induced in 5 patients (36%). Wall motion abnormalities of the right
ventricle were detected in 4 patients (29%) and endomyocardial biopsy revealed features of cardiomyopathy in 7
patients (50%). In total, 9 (64%) of 14 patients exhibited wall motion abnormalities and/or pathologic findings.
Conclusions Underlying cardiomyopathy was present in more than half of the present patients with ST-segment
elevation in the right precordial leads. (Circ J 2006; 70: 719 – 725)
Key Words: Cardiomyopathy; Electrocardiography; Right precordial leads; ST-segment elevation
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