Board Review: Cardiology
A 60-year-old man presents with chest pain. His EKG shows ST elevations in leads II, III and aVF as well as ST depressions in V2 and V3. A right-sided electrocardiogram is also performed and shows elevated ST segments in V4R and V5R. Which of the following medications is contraindicated?
C. IV fluids
Answer: B - Nitroglycerin
-always suspect right ventricle infarction in any patient with an inferior STEMI and ask for a right sided EKG.
-ST elevation in lead III > II.
-ST depression in V2 and ST elevation in V1.
-these patients are preload dependant and should be treated with IV fluids for hypotension; nitroglycerin is contraindicated.
-they can be complicated by high degree AV block.