What is the treatment for an inferior MI?
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 do you not give Nitro to 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.
How is right sided MI treated?
The current treatment of RVMI patients, other than the optimization of RV and LV preload with intravenous fluids, the administration of inotropic agents, and revascularization, includes the maintenance of atrioventricular synchrony, intra-aortic balloon pump counterpulsation, and more intensive mechanical support.
What is V4R ECG?
V4R shows loss of R-wave height, significant ST elevation (> 0.5mm; ST segment > R wave) and hyperacute T wave (very large T wave given amplitude of QRS complex) – this confirms the diagnosis of RV MI.
What are inferior leads?
The arrangement of the leads produces the following anatomical relationships: leads II, III, and aVF view the inferior surface of the heart; leads V1 to V4 view the anterior surface; leads I, aVL, V5, and V6 view the lateral surface; and leads V1 and aVR look through the right atrium directly into the cavity of the …
Why is there hypotension in inferior wall MI?
Up to 60% of patients with inferior wall acute myocardial infarction (AMI) develop hypotension. In many cases, profound hypotension is precipitated by the administration of nitroglycerin.
What is inferior 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 part of the heart is affected by an inferior MI?
While inferior wall MIs traditionally have a good prognosis, there are a few factors that may increase mortality. Approximately 40% of inferior wall infarctions also involve the right ventricle. Right ventricular infarctions are very pre-load dependent, and nitrates may precipitate a drop in blood pressure.
What causes right ventricular MI?
Criteria for Acute Ischemic Right Ventricular Dysfunction With RV infarction, the ECG may show an acute anterior Q-wave pattern (leads V1 through V3) as well as a right-sided Q pattern (leads V3R through V6R).
What are the signs and symptoms of inferior MI and RVMI?
When inferior MI is associated with RVMI, patients show more bradycardia, need for pacing, hypotension, and mortality. NCBI Skip to main content Skip to navigation Resources
How is right ventricular infarction (RV infarction) indicated in inferior STEMI?
In patients with inferior STEMI, right ventricular infarction is suggested by: ST elevation in V1 and ST depression in V2 (highly specific for RV infarction) Isoelectric ST segment in V1 with marked ST depression in V2 Diagnosis is confirmed by the presence of ST elevation in the right-sided leads (V3R-V6R)
What is inferior wall myocardial infarction (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. In most patients, the inferior myocardium is supplied by the right coronary artery.
How is V4R used to diagnose rheumatoid arthritis?
The most useful lead is V4R, which is obtained by placing the V4 electrode in the 5th right intercostal space in the midclavicular line. ST elevation in V4R has a sensitivity of 88%, specificity of 78% and diagnostic accuracy of 83% in the diagnosis of RV MI.