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• '''In patients with hypotension (without pulmonary congestion):
• '''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)
:❑ 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>  
|C03=<div style="float: Center; text-align: left;"> • '''Systemic or pulmonary vasodilators:'''<br>  
:❑Nitrosrusside
:❑Nitrosrusside
:❑Inhaled nitric oxide<be>
:❑Inhaled nitric oxide<be>
|C04=• '''In patients with bradyarrhthmias:'''<br>  
|C04=<div style="float: Center; text-align: left;"> • '''In patients with bradyarrhthmias:'''<br>  
:❑Atropine  
:❑Atropine  
:❑Pacemaker
:❑Pacemaker
• '''In patients with atrioventricular block:'''<br>  
• '''In patients with atrioventricular block:'''<br>  
:❑Temporary dual-chamber pacemaker
:❑Temporary dual-chamber pacemaker
|C05='''In patients with refractory hypotension:'''<br>   
|C05=<div style="float: Center; text-align: left;"> '''In patients with refractory hypotension:'''<br>   
:❑Dobutamine (along with fluids)
:❑Dobutamine (along with fluids)
:❑Other inotropes:
:❑Other inotropes:
*milrinone
*milrinone
*norepinephrine
*norepinephrine
|C06= May be needed in patients with cardiogenic shock secondary to RVMI:
|C06= <div style="float: Center; text-align: left;"> • '''May be needed in patients with cardiogenic shock secondary to RVMI''':
:❑Direct RV support
:❑Direct RV support
:❑Indirect RV support
:❑Indirect RV support

Revision as of 18:15, 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
 
 
{{{ }}}