Isolated right ventricular infarction: Fatal dissection and shock requiring invasive therapies

Abstract

A 78-year-old female with a history of dyslipidemia and hypertension presented with chest tightness and pain. On presentation she was noted to be hypertensive with ECG significant for ST elevation in leads II, III, aVF, as well as leads V2-V6. Coronary angiogram indicated 99% stenosis of the right coronary artery (RCA); however, within hours of receiving a drug eluting stent to the diseased artery, the patient had recurrent chest pain concerning for in-stent thrombosis. The catheterization was complicated by complete heart block, coronary artery dissection, and subsequently cardiogenic shock. The extent of this patient’s morbidity and ultimately mortality caused by isolated right ventricular myocardial infarction secondary to single vessel disease, despite aggressive interventional life support makes this case unique.