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{{familytree | | | C01 | | | C02 | | | C03 | | C04 | | C05 | | C06 | | |
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|C01=<div style="float: Center; text-align: left; width: 12em; padding:1em;"> •'''Thrmobolytics''' <br> •'''Percutaneous coronary intervention (PCI)''' <br>
|C01=<div style="float: Center; text-align: left; padding:1em;"> •'''Thrmobolytics''' <br> •'''Percutaneous coronary intervention (PCI)''' <br>
|C02= • '''Avoidance of preload reducing agents''', such as:<br>
|C02= • '''Avoidance of preload reducing agents''', such as:<br>
:❑Nitrates  
:❑Nitrates  

Revision as of 18:12, 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:
  • milrinone
  • norepinephrine
 
May be needed in patients with cardiogenic shock secondary to RVMI:
❑Direct RV support
❑Indirect RV support
❑Biventricular support
 
 
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