Sandbox:Mitra3: Difference between revisions

Revision as of 18:07, 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

{{{ }}}

@@ Line 12: / Line 12: @@
 :❑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)
 |C03=• '''Systemic or pulmonary vasodilators:'''<br>
+:❑Nitrosrusside
 :❑Inhaled nitric oxide<be>
 |C04=• '''In patients with bradyarrhthmias:'''<br>
 :❑Atropine
 :❑Pacemaker
+• '''In patients with atrioventricular block:'''<br>
+:❑Temporary dual-chamber pacemaker
 |C05=• '''In patients with refractory hypotension:'''<br>
-|C06= May be needed in patients with cardiogenic shock secondary to RVMI}}
+:❑Dobutamine (along with fluids)
+:❑Other inotropes:
+*milrinone
+*norepinephrine
+|C06= May be needed in patients with cardiogenic shock secondary to RVMI:
+:❑Direct RV support
+:❑Indirect RV support
+:❑Biventricular support
+}}
 {{familytree/end}}