Patient with substernal chest pressure for 3 hours, BP: 80/58, you will send him for cath lab, what additional ttt you should give prior to this?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: B. IV normal saline bolus
The ACS patient is hypotensive (80/58). Nitrates (and morphine) worsen hypotension and are avoided in hypotension/RV infarction; beta-blockers are given only if there is no hypotension or heart failure; diuretics drop preload. In a hypotensive ACS patient (classically RV/inferior infarction, which is preload dependent), an IV normal saline bolus supports BP before the cath lab. The stem probably lost details (e.g. inferior/RV involvement), but B is the only option not contraindicated by hypotension.
ليش كل خيار صح أو غلط
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A
ليش غلط
Diuretics lower preload; right-ventricular infarction is preload dependent, so nitrates and diuretics are not given.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 16 -
B
ليش صح
In a hypotensive inferior/RV infarct, patients are preload dependent: IV fluid raises cardiac output and BP, whereas nitroglycerin is avoided.
✓ 4• Coronary Artery Disease [Notes].pdf · p. 4 -
C
ليش غلط
Nitroglycerin is avoided if there is hypotension or an RV infarct; BP is 80/58.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 14 -
D
ليش غلط
Morphine also causes venodilation and reduces preload, which would worsen this low BP; it is used with caution.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 14 -
E
ليش غلط
A beta-blocker such as metoprolol is given only if no hypotension or heart failure; the BP here is 80/58.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 14
- المصدر
- Step-Up To Medicine 6th (IHD & ACS).pdf · p. 14
4• Coronary Artery Disease [Notes].pdf · p. 4 - المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
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