[Prospective study of the value of echocardiography and myocardial scintigraphy with Tc 99m pyrophosphate during the acute stage of right ventricular infarction].

The aim of this study was to compare the clinical values of 99mTc pyrophosphate scintigraphy and M mode and 2D echography in the diagnosis of right ventricular infarction and in the predicting of some of its complications. Fifty-two patients were prospectively studied by echocardiography and scintigraphy at the acute stage of inferior wall infarction. Scintigraphy was performed in the antero-posterior and 45 degrees left anterior oblique incidences during the first 3 days of infarction. Right ventricular infarction was diagnosed if the right ventricular fixation was separated from the left ventricle by fixation at the base of the septum. Echocardiography was performed at an early stage by the usual 3 incidence. Dilatation of the right ventricle on the parasternal and submitral incidences; abnormal right ventricular contraction was searched for in all the incidences. The following results were obtained: scintigraphy showed a localised fixation allowing a topographic study in 40/52 patients (77%); satisfactory echocardiographic studies were obtained in 46/52 patients (88.5%). Signs of right ventricular infarction: scintigraphy showed signs of necrosis of the right ventricle in 12/40 patients (30%) who had a localised fixation; echocardiography showed dilatation (greater than 25 mm) of the superior part of the right ventricle with a right/left ventricle ratio greater than 0.5 in 16/46 patients (37%) with interpretable studies and obvious abnormalities of right ventricular wall motion in 7 patients (15.2%), less obvious in 10 other patients (22%).(ABSTRACT TRUNCATED AT 250 WORDS)