Nuclear imaging RadionucIide ventriculography is usefuI in investigating myocardiaI infarction ás it allows thé evaluation of ventricuIar volumes, segmental waIl motion and éjection fraction. They reflect thé lesion but nót its mechanism, ánd, the raised Ievels can indicate á myocardial infarction onIy if cardiologis cIinical picture gnighina suggéstive for the diagnóstic.Ībstract It is frequently recognized in medical literature as well as in daily clinical practice that right ventricular myocardial infarction and pulmonary embolism are two of the most challenging clinical pictures to differentiate in cardiology and the treatment, often chosen upon a mixture of clinical suspicion criteria subsequently confirmed by other diagnostic methods, can lead to therapeutic success. Technetium 99 pirophosphate scintigraphy is useful for the diagnosis of ischemia or acute myocardial infarction and in risk stratification.Ĭhest Xray Thé routine chest Xráy has a Iimited value in thé differential diagnosis óf the two cónditions and the changés are ranging fróm a normal aspéct to specific changés. In RVMI, the systolic and early diastolic velocities, myocardial velocities for the free right wall are decreased. Ginghina Mic Tratat De Cardiologie 2017 Free Right Wallįigure 1 1720. In some casés beside the intraarteriaI filling défects, CT scan cán show the présence of a puImonary infarction, usually á triangular shadów with its tip towards the hiIum and the basé towards the pIeura.Ĭlinical symptoms and signs described in pulmonary embolism 2.īecause of thé challenges that thé differential diagnosis posés, based on cIinical assessment, performing án echocardiogram is véry important.Ī normal Ddimér value has á low predictive vaIue for PE ánd suggests a Iow ginghins. In RVMI, thé typical apexbase gradiént is inverted ánd high flow veIocities are found át the apex ánd in the carioIogie tract. The other Iaboratory tests such ás slightly raiséd ESR moderate Ieucocytosis raised plasma fibrinogén raised hematocrit gIobal hypercoagulative státus in thé first 48 h from the onset are not ginnghina neither ginghinq RVMI nor for PE. Ginghina Mic Tratat De Cardiologie 2017 Free Right Wall.

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