What medication is contraindicated in inferior MI?

What medication is contraindicated in inferior 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.

Why is nitroglycerin contraindicated in inferior wall MI?

Patients with inferior ST elevation myocardial infarction (STEMI), associated with right ventricular infarction, are thought to be at higher risk of developing hypotension when administered nitroglycerin (NTG).

What does probable inferior infarct mean?

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.

Which of the ECG findings would be positive for an inferior wall MI?

Upon ECG analysis, inferior STEMI displays ST-elevation in leads II, III, and aVF. There are subtle differences in the ECG pattern depending on the artery occluded. Reciprocal changes (ST-segment depression) may be seen in lead aVL [6].

Which drugs are contraindicated in MI?

XI. Precautions: NSAIDS are contraindicated (esp. post-STEMI)

• Consider NSAIDs as a medication allergy in post-STEMI patients.
• Choose non-NSAID agents first: Acetaminophen, Tramadol.
• Consider non-acetylated Salicylates (Exercise caution due to peptic ulcer risk) Aspirin.
• If pain refractory to non-NSAID Analgesics.

What is the drug of choice for myocardial infarction?

The pain of myocardial infarction is usually severe and requires potent opiate analgesia. Intravenous diamorphine 2.5–5 mg (repeated as necessary) is the drug of choice and is not only a powerful analgesic but also has a useful anxiolytic effect.

When is nitroglycerin contraindicated in MI?

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.

When do you not use nitroglycerin in Michigan?

Despite the lack of strong evidence, AHA warns that NTG should be used with caution (if at all) in patients with ECG evidence of inferior wall STEMI when one suspects right ventricular involvement [4]. However, when right ventricular infarction is confirmed, NTG is generally contraindicated [4].

Is inferior myocardial infarction serious?

Inferior myocardial infarctions have multiple potential complications and can be fatal. See the review on ST elevation myocardial infarction for more detail on complications of an inferior myocardial infarction and a detailed discussion on treatment.

How is inferior infarct treated?

Fluid infusion is the mainstay of treatment for patients with RVI. In the case of an inferior MI with right ventricular involvement, the administration of nitroglycerin and morphine could cause an abrupt drop in blood pressure.

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.

Why are ACE inhibitors used after MI?

In most of the large mortality trials the rationale for use of ACE inhibitors after myocardial infarction was stated to be their likely beneficial effect on “remodeling” of the heart after “Infarct expansion.” Because adverse remodeling occurs in only a proportion of patients after a heart attack, the benefits of ACE …