2.50
Hdl Handle:
http://hdl.handle.net/10755/157956
Type:
Presentation
Title:
Right-Sided S3/S4 Heart Sounds in Right Ventricular Infarct: A Meta-Analysis
Abstract:
Right-Sided S3/S4 Heart Sounds in Right Ventricular Infarct: A Meta-Analysis
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Lee, Eunyoung, RN, MN, MSN
P.I. Institution Name:University of California, San Francisco
Title:PhD Student
Co-Authors:Barbara Drew
Background and significance: Acute right ventricular myocardial infarction (MI) occurs in as many as 50% of MIs of the left ventricular inferior wall. It is important to identify which patients with acute inferior wall MI have right ventricular involvement because treatment is different. For example, if hypotension develops, the treatment for right ventricular MI is to augment preload (intravenous fluids, avoidance of diuretics and vasodilators), which would be inappropriate treatment for inferior MI without right ventricular involvement. Diagnosis of right ventricular MI requires recording of a second ECG with leads placed over the right precordium. Ideally, all patients with evidence of acute inferior MI should have this 2nd ECG recorded; however, this requires extra time and training. In a busy emergency department, right ventricular leads are often not recorded. It would be beneficial to have a non-ECG parameter to indicate the likelihood of right ventricular MI. Aims: The purpose of this study was to investigate whether extra heart sounds, S3 and S4, might be helpful to identify patients likely to have right ventricular MI. Specifically, the aim was to compare the frequency of S3 and S4 in acute MI with and without right ventricular involvement. Methods: From the systemic approach of a meta-analysis, seven studies involving 279 patients were identified via a MEDLINE search in which S3 and S4 were measured by auscultation or phonocardiogram during acute MI. One study included patients with right ventricular MI; six studies comprised the no-right ventricular MI group. Results: Patients with right ventricular MI had a higher frequency of S3 heart sounds than patients without right ventricular MI. In contrast, patients without right ventricular MI had a higher frequency of S4 heart sounds than patients with right ventricular MI. Conclusion/Implication: The frequency of extra heart sounds in acute MI varies in patients with and without right ventricular involvement. The presence of a S3 heart sound in patients with ST segment changes of acute inferior MI may assist in identifying patients who should have a right ventricular ECG recording to assess whether they have concomitant right ventricular infarction.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRight-Sided S3/S4 Heart Sounds in Right Ventricular Infarct: A Meta-Analysisen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157956-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Right-Sided S3/S4 Heart Sounds in Right Ventricular Infarct: A Meta-Analysis</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lee, Eunyoung, RN, MN, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California, San Francisco</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">PhD Student</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">elee@itsa.ucsf.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Barbara Drew</td></tr><tr><td colspan="2" class="item-abstract">Background and significance: Acute right ventricular myocardial infarction (MI) occurs in as many as 50% of MIs of the left ventricular inferior wall. It is important to identify which patients with acute inferior wall MI have right ventricular involvement because treatment is different. For example, if hypotension develops, the treatment for right ventricular MI is to augment preload (intravenous fluids, avoidance of diuretics and vasodilators), which would be inappropriate treatment for inferior MI without right ventricular involvement. Diagnosis of right ventricular MI requires recording of a second ECG with leads placed over the right precordium. Ideally, all patients with evidence of acute inferior MI should have this 2nd ECG recorded; however, this requires extra time and training. In a busy emergency department, right ventricular leads are often not recorded. It would be beneficial to have a non-ECG parameter to indicate the likelihood of right ventricular MI. Aims: The purpose of this study was to investigate whether extra heart sounds, S3 and S4, might be helpful to identify patients likely to have right ventricular MI. Specifically, the aim was to compare the frequency of S3 and S4 in acute MI with and without right ventricular involvement. Methods: From the systemic approach of a meta-analysis, seven studies involving 279 patients were identified via a MEDLINE search in which S3 and S4 were measured by auscultation or phonocardiogram during acute MI. One study included patients with right ventricular MI; six studies comprised the no-right ventricular MI group. Results: Patients with right ventricular MI had a higher frequency of S3 heart sounds than patients without right ventricular MI. In contrast, patients without right ventricular MI had a higher frequency of S4 heart sounds than patients with right ventricular MI. Conclusion/Implication: The frequency of extra heart sounds in acute MI varies in patients with and without right ventricular involvement. The presence of a S3 heart sound in patients with ST segment changes of acute inferior MI may assist in identifying patients who should have a right ventricular ECG recording to assess whether they have concomitant right ventricular infarction.</td></tr></table>en_GB
dc.date.available2011-10-26T20:22:04Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:22:04Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.