Right ventricular ST-elevation myocardial infarction as a cause of death in idiopathic pulmonary arterial hypertension.

Abstract

A 32-year-old woman with advanced idiopathic pulmonary arterial hypertension (PAH), treated with oral tadalafil and intravenous epoprostenol, presented with typical angina pectoris of one day's duration. Her electrocardiogram, previously typical of pulmonary hypertension, revealed an acute ST-elevation myocardial infarction in the anterior precordial leads. She had a prior coronary angiogram, in preparation for lung transplantation, that revealed normal coronary arteries. Urgent coronary angiography showed acute occlusion of several acute marginal coronary branches that feed the right ventricle (RV). Coronary angioplasty and stenting was unable to adequately restore coronary perfusion. Despite support, she developed progressive cardiogenic shock and died three days later. This is an unusual complication of PAH.

• Authors: Yang Zhan, Barry Burstein, Ali O Abualsaud, Mohamed Nosair, Andrew M Hirsch, Lyda Lesenko, David Langleben
• Journal: Pulmonary circulation (Pulm Circ) 2017 Apr-Jun Vol. 7 Issue 2 Pg. 555-558 ISSN: 2045-8932 [Print] United States
• PMID: 28597772 (Publication Type: Case Reports)