What clinical signs on physical examination would you expect in a non-ventilated patient with a right ventricular infarct? (25% marks)
Part b was answered poorly - candidates listed the signs of right ventricular failure, not of a right ventricular infarct.
The signs of right heart failure, which we were not supposed to specifically mention, would surely develop with a right sided infarct, and therefore reveal it to be right sided.
"The clinical triad of hypotension, clear lung fields, and elevated jugular venous pressure in a patient with an inferior infarction is virtually pathognomonic for right ventricular infarction." However, the triad has a sensitivity of 25% (Kinch et al; 1994). Other signs may include:
Anyway: features of right heart failure will not have time to develop with acute infarction, but here they are anyway:
Lorell, Beverly, et al. "Right ventricular infarction: clinical diagnosis and differentiation from cardiac tamponade and pericardial constriction." The American journal of cardiology43.3 (1979): 465-471.
Kinch, Jack W., and Thomas J. Ryan. "Right ventricular infarction." New England Journal of Medicine 330.17 (1994): 1211-1217.