Acute myocardial infarction involving only the free wall of the right ventricle is a rare event. ^[1] More commonly, right ventricular infarction is associated with infarction of the inferior wall of the left ventricle, occurring in more than one-third of such cases,^{[2] [3] [4] [5] [6] [7] [8] [9] [10]} even when a thrombolytic therapy is given. ^[11]

One study of 113 patients with a first acute inferior wall infarction reported that the presence of preinfarction angina within 72 hours of the infarction was associated with a reduction in the incidence of right ventricular infarction (odds ratio 0.2) and combined hypotension and shock (odds ratio 0.1). ^[12] This is possibly the result of ischemic preconditioning.

• Ninety percent of right ventricular infarcts result from occlusion of the proximal right coronary artery, while another 5 to 10 percent arise after occlusion of the left anterior descending artery ^{[13] [14] [15] [16]}

Although more than one-third of cases are clinically silent ^[17], the presence of right ventricular infarction often has important implications for both management and prognosis.