Is nitroglycerin contraindicated in inferior wall MI?

Nitroglycerin is also contraindicated in the setting of an inferior MI with right ventricular involvement because, in this specific situation, the heart is dependent on preload.

Can nitrates be given in inferior wall MI?

Thus, in the setting of an inferior AMI, a marked hypotensive response to nitrates suggests the presence of RV involvement. Moreover, hypotension after nitrate administration may be anticipated in patients with known RV infarction, and in such patients, nitrates should be administered carefully.

How do you identify inferior MI?

The ECG findings of an inferior ST segment elevation myocardial infarction include:

1. ST segment elevation in the inferior leads (II, III, and aVF) of at least 1 mm.
2. Reciprocal ST segment depression in the lateral and/or high lateral leads (I, aVL, V5 and V6).

When do you not give nitroglycerin MI?

“Nitrates should not be given to patients with hypotension, marked bradycardia or tachycardia, RV infarction, or 5’phosphodiesterase inhibitor use within the previous 24 to 48 hours.”

When do you not give Nitro?

Nitroglycerin is contraindicated in patients that have reported allergic symptoms to the medication. [18] Known history of increased intracranial pressure, severe anemia, right-sided myocardial infarction, or hypersensitivity to nitroglycerin are contraindications to nitroglycerin therapy.

What is the earliest indicator that he is experiencing an inferior wall myocardial infarction?

In the earliest hours of acute IMI, the ST-segments in II, III and aVF may be normal or near-normal, but frequently, there is ST-segment depression in aVL. Thus, ST-segment depression in AVL constitutes a critical “early warning” sign of acute inferior wall STEMI.

Do you give Nitro for stemi?

One therapy, the use of nitrates such as nitroglycerin (NTG), continues to be used in the management of acute ischemic chest pain due to ST-elevation myocardial infarction (STEMI).

Why are nitrates avoided in right sided MI?

Diuretics and nitrates, which reduce preload, can diminish cardiac output and induce significant hypotension in the presence of right ventricular infarct. They must be used with caution in this setting.

How is inferior MI treated?

The traditional field treatment for an MI is aspirin and oxygen, with nitroglycerin and morphine for pain (often referred to as MONA). Some services now administer angiotensin converting enzyme (ACE) inhibitors, clopidogrel, and beta-blocking drugs as well.

What stemi do you not give Nitro to?

2013 AHA/ACC STEMI Guidelines: “Nitrates should not be given to patients with hypotension, marked bradycardia or tachycardia, RV infarction, or 5’phosphodiesterase inhibitor use within the previous 24 to 48 hours.”

What type of STEMI do you not give Nitro?

What is inferior wall MI?

Inferior wall myocardial infarction (MI) occurs from a coronary artery occlusion with resultant decreased perfusion to that region of the myocardium. Unless there is timely treatment, this results in myocardial ischemia followed by infarction.

What does angina look like on an ECG?

You have 3 more open access pages. The ECG is usually normal between attacks. During an attack there may be a transient ST segment depression, symmetrical T wave inversion or tall, pointed, upright T wave may appear.