Right ventricular free wall
Territory
Thin-walled and low-pressure, so it is perfused in systole as well as diastole and tolerates ischaemia better than the left ventricle; RV function usually recovers over weeks.
Traced from the start
- Right (anterior) aortic sinus
- Right coronary artery
- Right (acute) marginal artery
- Right ventricular free wall
Detail
- Supplied by
- RCA via the acute marginal and RV branches; conus branch to the outflow tract
- Leads
- V4R (right-sided chest lead); ST elevation in V1 on the standard ECG
When it goes wrong
Right ventricular infarction
Hypotension with a raised JVP and clear lung fields (Kussmaul sign may be present)
Giving nitrates, diuretics or morphine to a patient with RV infarction
Profound hypotension because the failing RV is preload-dependent; treat with intravenous fluid instead
Practise this structure
1 question in the bank tagged Myocardial Oxygen Supply.