Context In view of the right ventricular (RV) volume pump traits, right ventricular injury (RVI) with hemodynamic compromise needs a specific treatment [1]. RVI in ST-elevation myocardial infarction (STEMI) can cause intense hemodynamic derangements and is associated with increased mortality and morbidity [2]. The primary cause of death in sufferers with acute right ventricular myocardial Infarction (RVMI) is cardiogenic shock [3]. Therefore, early and accurate diagnosis is essential for optimizing treatment strategies. In medical practice, echocardiography provides major tool for evaluation of RV structure and function. In comparison to other modalities, it provides added advantages of versatility and easy availability. Aims

• To evaluate and compare Echocardiographic Methodologies in Inferior Wall Myocardial Infarction with Right Ventricular Myocardial Infarction and it’s dysfunction assessment with it’s prognostic implication in assessing the risk of mortality in different sub groups.

Setting and Design: This study was performed in the Department of General Medicine, Mata Gujri Memorial Medical College and Lions Sewa Kendra Hospital, Kishanganj, Bihar for 100 consecutive patients admitted with IWMI during the period of March 2022 – December 2022, for a period of 10 months. The study is a prospective observational study. Material and methods: Group 1 – Patients with IWMI with RVMI on ECG (n = 47) Group 2 – Patients with IWMI without RVMI on ECG (n = 53) within 48 hours of onset of symptoms and within 24 hours whenever feasible, Transthoracic echocardiography performed in all patients. Statistical analysis used: Comparison of measurements between Group 1 and group 2 was performed using a two tailed Student’s t-test. Results

• The end-diastolic diameter of RV was increased in patients with RVMI. In half of the patients with right ventricular involvement, Tricuspid Regurgitation was noted which was mild in majority of cases.
• There was a significant statistical decrease noted in Tricuspid Annular Plane Systolic Excursion (TAPSE) in patients with right ventricular myocardial infarction. Nearly two-fold rise in Myocardial Performance Index (MPI) was noted as compared to the reference values in patients with RVMI.

Conclusions: The dimensions and contractility of right ventricle were considered insignificant in detecting RVMI. Raised MPI values were associated with higher mortality. RV functional abnormality was worse in patients whose echo was done within 24 hrs. The systolic velocity of Right Ventricle in RVMI patients was less in comparison to patients without RVMI.