Study Assesses Nitroglycerin's Effect on Hypotension in STEMI Patients

This study was designed to determine if nitroglycerin (NTG) administration is more likely to cause hypotension in patients with an inferior wall ST elevation myocardial infarction (STEMI) versus one somewhere else in the heart. The authors defined hypotension as systolic blood pressure < 90 mmHg. They also examined the frequency of systolic blood pressure dropping more than 30 mmHg after NTG administration. The information was extracted from retrospective chart review of 1,488 EMS reports that had EMS 12-lead ECGs for which the computer interpretation was “acute MI.” They found that hypotension occurred as often in the inferior STEMI (8.2%) as it did in the noninferior STEMI (8.9%) and that systolic blood pressure dropped more than 30 points in 23.4% of the inferior and 23.9% of the noninferior STEMIs. The authors concluded that there was no difference in NTG-induced hypotension between the inferior and non-inferior STEMIs and that “computer interpretation of the inferior STEMI cannot be used as the sole predictor for patients who may be at a higher risk for hypotension following NTG administration.” MEDIC WESLEY COMMENTS Again, another study that disproves what we prehospital providers are currently taught. It’s just been the last few years that the emphasis on right side ECG leads has become the standard to rule out right ventricular (RV) infarct. I’m not sure that even with the evidence of this study that it will allow us to disregard the concerns of NTG in ...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Special Topics Cardiac & Resuscitation Research Columns Patient Care Source Type: news