Which clinical finding represents a contraindication to the administration of nitro?

Which clinical finding represents a contraindication to the administration of nitro?

• A. Hypotension
• B. Confirmed right ventricular infarction (RV)
• C. Pulmonary edema
• D. Bradycardia

Answer: (B)

Nitrates like nitroglycerin lower preload by dilating veins, which reduces the amount of blood returning to the heart. In a confirmed right ventricular infarction, the right ventricle cannot pump effectively, so the body relies on adequate preload to keep left-sided filling and cardiac output. Reducing preload in this situation markedly drops LV filling and cardiac output, leading to dangerous hypotension. That preload-dependency makes right ventricular infarction a clear contraindication to nitro. Context: while other scenarios may raise caution with nitroglycerin (for example, very low blood pressure), the specific finding described here directly creates a situation where nitro’s preload-reducing effect would compromise hemodynamics.

Nitrates like nitroglycerin lower preload by dilating veins, which reduces the amount of blood returning to the heart. In a confirmed right ventricular infarction, the right ventricle cannot pump effectively, so the body relies on adequate preload to keep left-sided filling and cardiac output. Reducing preload in this situation markedly drops LV filling and cardiac output, leading to dangerous hypotension. That preload-dependency makes right ventricular infarction a clear contraindication to nitro.

Context: while other scenarios may raise caution with nitroglycerin (for example, very low blood pressure), the specific finding described here directly creates a situation where nitro’s preload-reducing effect would compromise hemodynamics.