PubMed · 7798518
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D H Spodick. 1995. Exercise echocardiography.. https://doi.org/10.1016/0735-1097(94)00333-l
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Conventional criteria of ST segment elevation in right sided chest leads or loss of initial 'r' wave in leads V3R or V4R have low sensitivity and specificity in diagnosing right ventricular involvement in the presence of left ventricular posterior infarction. Slurring of R wave either in right sided chest leads or in lead aVR can diagnose right ventricular involvement in such a setting with a sensitivity of 70% and specificity of 94%.
Pericardial agenesis is a rare anomaly, difficult to diagnose. Its evolution is usually benign. However, on rare occasions, partial defects have been the cause of sudden death. Therefore, surgical treatment has sometimes been indicated, even though in the cases were asymptomatic. We report the case of a 50 year-old woman with partial pericardial agenesis and herniation of left atrial appendage trough. The defect was discovered by a routine chest x-ray and treated in a conservative way. Current diagnostic and therapeutic techniques are reviewed.