Vectorial Theory Explains Eletrocardiographic Patterns of Right Ventricular Infarction

The myocardial infarction of the right ventricle needs specific therapeutics in case of occurrence of cardiogenic shock. However, the opportune diagnosis of the infarction of the right ventricle is rarely done due to difficulties in its determination.

The electrocardiography, which represents the most practical way for the diagnosis of myocardial infarction doesn’t give the interpretation of right ventricular infarction, inside of the ECG patterns based in the Heart Cavity Potential Theory (CPT), developed by Frank Norman Wilson almost 70 years ago prevailing until today’s.

In reality, the weakness about the Cavity Potential Theory was demonstrated by Wilson in 1932 through the epicardial leads of ECG, with the QS deflection recorded during experimental studies, finding which conflicted with his own concept.

Many years late (1958) Quintiliano H. de Mesquita identified the first case of right ventricular infarction with the diagnosis realized in vivo, inside new electrocardiographic patterns which confirm another old ECG concept called Vectorial Theory, giving the right explanation to these ECG patterns. After that, Doctor Mesquita in successive papers published at medical magazines (from 1960 until 1995), preconized the absolute compatibility of the isolated infarction of right ventricle with the Vectorial Theory.

The possibility to use the electrocardiographical diagnosis for both infarctions of right and left ventricles, the last under the conventional ECG patterns, also compatible with the Vectorial Theory, brings good news for the convenient therapeutics, as stressed by Cohn J.N. and col in 1974, in case of occurrence of cardiogenic shock during the right ventricular infarction (Am.J.Cardiology, 1974;33:209).

These authors showed the necessity for an early recognition of the infarction of right ventricle once the therapeutic is different and specific in this case. They also pointed out that while in the right ventricular infarction the liquid expansion represents the salvation; its use in the infarction of left ventricle is absolutely unfavorable.

In this manner it is demonstrated the importance to replace the Cavity Potential Theory by the Vectorial Theory ECG patterns to attend all myocardial infarction types in the electrocardiographical diagnosis.

More Information at: ECG Vectorial Theory of Myocardial Infarction

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