As Chris Thomas said, you absolutely DO NOT give Nitro for an inferior STEMI. Giving nitro can cause the SBP to significantly drop. In a patient is having a inferior stemi, you know that the right ventricle (RV) is involved and the RV is preload dependent. So if you have a hypotensive patient who’s experience of a inferior MI, you should give a fluid bolus titrated to a SBP > or = 90
You only know RV is involved if V4R has elevation. If it doesn't then Nitro is ok. BP >90 of course. I've had numerous inferior STEMIs where V4R wasn't elevated and given nitro.
Well it's a good tick.. However i don't think it's such a good idea to give nitro before knowing 3 things. 1. Allergies 2. Patients blood pressure.. and 3. if they got an back wall infarction. It could be deadly as it could trigger and irreversibel pressure loss.. Also if you take viagra he shouldn't have nitro either.. Moral of the story: it only takes a few minutes to get things right the first time.
