No nitroglycerin in which kind of MI?

No nitroglycerin in which kind of MI?

• A. Inferior
• B. Lateral
• C. Anterior
• D. Posterior

Answer: (A)

Nitrates lower preload by dilating veins. In an inferior-wall myocardial infarction, especially when the right ventricle is involved, the heart relies on adequate venous return to maintain cardiac output. Reducing preload with nitroglycerin can cause a dangerous drop in right-sided filling and blood pressure, potentially leading to shock. That’s why nitroglycerin is avoided in inferior MI when RV infarction is suspected or when the patient is hypotensive. If there’s no sign of right ventricular involvement and blood pressure is stable, nitrates may be used with caution to relieve chest pain. The other MI locations don’t carry the same, absolute preload-dependent risk, so they aren’t as clearly contraindicated.

Nitrates lower preload by dilating veins. In an inferior-wall myocardial infarction, especially when the right ventricle is involved, the heart relies on adequate venous return to maintain cardiac output. Reducing preload with nitroglycerin can cause a dangerous drop in right-sided filling and blood pressure, potentially leading to shock. That’s why nitroglycerin is avoided in inferior MI when RV infarction is suspected or when the patient is hypotensive. If there’s no sign of right ventricular involvement and blood pressure is stable, nitrates may be used with caution to relieve chest pain. The other MI locations don’t carry the same, absolute preload-dependent risk, so they aren’t as clearly contraindicated.