Which statement is NOT an indication for IV nitro in STEMI?

Which statement is NOT an indication for IV nitro in STEMI?

• A. Recurrent chest pain
• B. Pulmonary edema
• C. Hypertension
• D. Hypotension

Answer: (D)

The key idea is when IV nitroglycerin is helpful versus when it’s risky in STEMI. Nitroglycerin mainly dilates veins, lowering preload, and at higher doses can reduce afterload. This helps in scenarios where the heart is working hard or congested. - Recurrent chest pain: ongoing ischemia is eased by reduced myocardial oxygen demand and improved perfusion, so nitro is indicated. - Pulmonary edema: reducing preload lowers venous congestion and lung edema, improving breathing, so nitro is indicated. - Hypertension: lowering afterload and blood pressure can decrease myocardial workload and ischemia, so nitro is indicated. Hypotension, however, is not an indication. Giving nitroglycerin would lower BP further, risking inadequate coronary perfusion and shock, so it’s avoided in hypotensive patients.

The key idea is when IV nitroglycerin is helpful versus when it’s risky in STEMI. Nitroglycerin mainly dilates veins, lowering preload, and at higher doses can reduce afterload. This helps in scenarios where the heart is working hard or congested.

• Recurrent chest pain: ongoing ischemia is eased by reduced myocardial oxygen demand and improved perfusion, so nitro is indicated.

• Pulmonary edema: reducing preload lowers venous congestion and lung edema, improving breathing, so nitro is indicated.

• Hypertension: lowering afterload and blood pressure can decrease myocardial workload and ischemia, so nitro is indicated.

Hypotension, however, is not an indication. Giving nitroglycerin would lower BP further, risking inadequate coronary perfusion and shock, so it’s avoided in hypotensive patients.