Multimodality imaging of the ischemic right ventricle: an overview and proposal of a diagnostic algorithm

Working group of Echocardiography of Italian Society of Cardiology (SIC)

Research output: Contribution to journalReview articlepeer-review


Right ventricular (RV) involvement is frequently detected in patients presenting with acute left ventricular myocardial infarction. The ischemic right ventricle carries a dismal outcome by predisposing the heart to arrhythmic events and mechanical or hemodynamic complications. A comprehensive RV evaluation by multimodality imaging could guide clinical practice but has always been a conundrum for the imagers. Two-dimensional echocardiography is the best first-line tool due to its availability of bedside capabilities. More advanced imaging techniques provide a more comprehensive evaluation of the complex RV geometry but are mostly reserved for the post-acute setting. Three-dimensional echocardiography has improved the evaluation of RV volumes and function. The recent application of speckle-tracking echocardiography to the right ventricle appears promising, allowing the earlier detection of subtle RV dysfunction. Cardiac magnetic resonance imaging is considered the gold standard for the RV assessment. Cardiac multidetector computed tomography could be a reliable alternative. The aim of this review is to focus on the growing importance of multimodality imaging of the ischemic right ventricle and to propose a diagnostic algorithm, in order to reach a comprehensive assessment of this too frequently neglected chamber.

Original languageEnglish
Pages (from-to)3343-3354
Number of pages12
JournalInternational Journal of Cardiovascular Imaging
Issue number11
Publication statusPublished - Nov 2021


  • 2D-Echocardiography
  • 3D-Echocardiography
  • Cardiac magnetic resonance
  • Myocardial infarction
  • Right ventricle

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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