Sandbox:Mitra3: Difference between revisions

Revision as of 18:24, 3 August 2020

Therapuetic Considerations in RVMI

Reperfusion

Maintenance of RV preload

Decreased RV afterload

Restoring Rate/Rhythm and AV synchrony

Inotropic support

Mechanical Circulatory Support

•Thrmobolytics
•Percutaneous coronary intervention (PCI)

• Avoidance of preload reducing agents, such as:

❑Nitrates

❑Diuretics

❑Morphin

• In patients with hypotension (without pulmonary congestion):

❑ Intravenous administration of Fluids (N/S 0.9% at 40mL for 2L, to maintain CVP <15mmHg and PCWP between 18-24 mmHg)

• Systemic or pulmonary vasodilators:

❑Nitrosrusside

❑Inhaled nitric oxide<be>

• In patients with bradyarrhthmias:

❑Atropine

❑Pacemaker

• In patients with atrioventricular block:

❑Temporary dual-chamber pacemaker

In patients with refractory hypotension:

❑Dobutamine (along with fluids)

❑Other inotropes:

• May be needed in patients with cardiogenic shock secondary to RVMI:

❑Direct RV support

❑Indirect RV support

❑Biventricular support

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 |C02= <div style="float: Center; text-align: left;"> • '''Avoidance of preload reducing agents''', such as:<br>
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 :❑Direct RV support
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