Isolated acute occlusion of a large right ventricular branch of the right coronary artery following coronary balloon angioplasty: The only true 'model' to study ECG changes in acute, isolated right ventricular infarction

An isolated right ventricular infarction occurs rarely and dataon its electrocardiographic appearance and underlying angiographicallyproven cause are scarce. The electrocardiographic response ofacute right ventricular ischaemia is often obscured by the coexistingforces of the ischaemic mass of the inferior wall of the leftventricle when the right coronary artery itself becomes occluded.Percutaneous transluminal coronary angioplasty of the rightcoronary artery may cause an isolated occlusion of a right ventricularbranch. We encountered this phenomenon in nine patients. Inall, it led to acute isolated right ventricular ischaemia withST elevations in the right precordial leads (V₁–V₃, V₃Rand V₄R on the electrocardiogram. We conclude that the ECG pattern of pure right ventricular ischaemiacan be seen when an isolated occlusion of a large right ventricularbranch occurs, for example as a complication of percutaneoustranslummal coronary angioplasty.