A clinical case of right ventricular myocardial infarction in a patient with diabetes mellitus and Fahr’s disease

Right ventricular myocardial infarction (RVMI) is quite a rare and difficult to diagnose disease. The leading method in the diagnosis of RVMI is a standard electrocardiography (ECG) in 12 leads, but a reliable establishment of this pathology is possible only with the use of mirror-image right precordial leads. In the presented clinical case, a 68-year-old patient was admitted to the hospital with complaints of weakness in the right extremities, speech impairment, nausea and vomiting. A complete examination was carried out and conservative treatment was initiated. Despite the treatment being administered, the patient's condition continued to deteriorate progressively, and therefore it was decided to transfer the patient to the intensive care unit, where an ECG revealed the likelihood of ischemia of the anterolateral and lower walls. The next day, respiratory and cardiac arrest was diagnosed, and resuscitation measures had no effect. During autopsy, cardiomyocyte necrosis zones with perifocal inflammation were found in the myocardium of the right ventricle, corresponding to myocardial infarction within 6 to 12 hours. Clinical observation emphasizes the importance of timely diagnosis of RVMI, especially against the background of severe metabolic disorders in the organism caused by diabetes mellitus.