Cardiology

Answer 1 Pulmonary edema. Approximately 10% of patients with inferior or inferoposterior wall MI suffer a hemodynamically significant RV infarct. The triad of hypotension, jugular venous distension, and absence of dyspnea in the setting of inferior or inferoposterior wall MI is very specific for RV infarction.1 Common physical findings are the presence of RV S3, clear lung fields, Kussmaul’s sign (inspiratory increase in jugular venous pressure), and occasionally pulsus paradoxus (inspiratory decline in systolic blood pressure > 10 mm Hg). In the absence of left ventricular MI, pulmonary edema is uncommon. REFERENCE 1. Dell’Italia LJ, Starling MR, O’Rourke RA. Physical examination for exclusion of hemodynamically important right ventricular infarction. Ann Intern Med 1983;99:608-11. Click here to return to the questions

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