Right Ventricular Involvement in Inferior Myocardial Infarction Patients Using 2 Dimensional Speckle Tracking Echocardiography

Study Overview
=================
Brief Summary
-----------------
Right ventricular infarction usually occurs in association with inferior myocardial infarction in about 10-50% of the cases. Currently the presence of elevation in right pericordial leads is the most powerful indicator of right ventricular infarction. The incidence of right ventricular infarction is more in postmortem studies,meaning that Right ventricular infarction is underestimated, possible explanation for this difference could be explained that electrocardiographic sign of Right ventricular infarction disappear early or patients presented late.

Detailed Description
-----------------
The incidence of right ventricular infarction is more in postmortem studies,meaning that Right ventricular infarction is underestimated, possible explanation for this difference could be explained that electrocardiographic sign of Right ventricular infarction disappear early or patients presented late The role of Right ventricular systolic function in inferior myocardial infarction patients with or without Right ventricular infarction Had been studied. In our study we will Assess Right Ventricular infarction in patients of acute inferior myocardial infarction undergoing primary percutaneous coronary intervention by correlating electrocardiogram, Right ventricular systolic function by echocardiography with the angiographic finding.

Official Title
-----------------
Incremental Role of 2 Dimensional Speckle Tracking Echocardiography in Diagnosis of Right Ventricular Involvement in Patients With Inferior Wall Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Conditions
-----------------
Acute Myocardial Infarction of Inferior Wall Involving Right Ventricle (Disorder)

Intervention / Treatment
-----------------
* Diagnostic Test: Two dimensional Echocardiography


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients of recent acute inferior myocardial infarction. Patients managed by Primary percutaneous coronary intervention. Exclusion Criteria: Pervious inferior Myocardial Infarction. Inferior Myocardial Infarction treated by thrombolytic therapy. Chronic pulmonary disease. estimatedPulmonary Artery Systolic Pressure ≥35 mmHg by Echocardiography. Valvular heart disease. 6- Dilated cardio-myopathy patients.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Two dimensional Echocardiography|I- Routine transthoracic assessment for Left Atrium and Left Ventricle dimensions : II- transthoracic assessment of the Right ventricular systolic function by: . Right Ventricle fractional area change. . Tricuspid annular plane systolic excursion . . Tissue Doppler derived tricuspid annular systolic velocity. . Right ventricle myocardial performance index . III- Assessment of Right ventricular diastolic function: is carried out by pulsed Doppler of the tricuspid inflow, or tissue Doppler of the lateral tricuspid annulus. IV Assessment of Right Ventricle chamber quantification: Right ventricular basal, mid ,and longitudinal dimensions. Right ventricular Outflow Tract, and wall thickness V- Assessment of right atrial major ,and minor dimensions ,and right atrial End- systolic area IV- Assessment of longitudinal Right ventricular strain and strain rate by speckle tracking|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Right ventricular dysfunction | right ventricular dysfunction by Echocardiography as indicator of right ventricular infarction in inferior wll myocardial patients | 3days |