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Bradycardia with hypotension may be due to inferior wall MI associated with right ventricular MI. If this is the case, avoid the use of nitrates (nitroglycerine). If bradycardia and hypotension exists, pacing and IV fluids may improve the patients...
Inferior-Posterior Wall MI (Example 4) Anterior Ischemia - (Example) STEMI with a Paced Rhythm (Example) … Sinus Bradycardia (Example 1)
Patients with acute inferior wall MI tend to be "parasympathetic" and have a high vagal tone. This explains the sinus bradycardia and lower blood pressure manifested by such patients.
Bradycardia is often seen in inferior wall acute MI (30-40% of patients), and within the first hour of acute MI. The Bezold-Jarisch reflex consists of bradycardia occurring with recanalization of the right coronary artery.
But, hypotension + bradycardia = possible inferior wall MI with RV infarct. You could be right, but as I mentioned, I just don't think enough information has been given to make a fully educated decision.
Inspite of the above factors inferior MI can not be taken lightly . Especially when it extend into posterior, lateral , (Rarely anterior) segments. is the only clue.
Junctional Bradycardia: • Seen in up to 20% of patients with AMI when the SA node fails to generate an impulse or where there is complete heart block. • Commonly encountered with inferior MI. • ECG will show no P waves.
Another common cause is suppression of the sinus node by beta blockers. In early stages of inferior wall myocardial infarction, sinus bradycardia is often observed. Sinus bradycardia also occurs during vasovagal syncope.
Myocardial infarction. –More common with inferior wall MI. Atrial fibrillation/flutter with high-degree block. tolerance of it, bradycardia may be transient or sustained, benign, or...
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Other, less healthy causes of sinus bradycardia can include irregular sleep patterns, sleep apnea, hypothyroidism, inferior wall myocardial infarction, hypothermia, hypoglycemia, increased intracranial pressure, seizures, and electrolyte disorders.
Bradycardic rhythms are more common with inferior wall MI in the setting of anterior wall MI, bradycardia.
Topics Discussed: acute coronary syndromes; cardiogenic shock; myocardial infarction of inferior wall, acute; percutaneous coronary intervention.
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This is especially associated with acute inferior wall MI. Symptoms emerge only when the bradycardia is severe. When symptomatic, the treatment consists of elevating the foot of the bed and giving intravenous atropine, 600 μg if no improvement.
myocardial infarction. In old myocardial infarction it could be because the person is on beta blockers for secondary prevention.
Even in the era of PCI, RV involvement in acute inferior MI is still an independent marker for increased mortality.6 Despite a similar atrial infarction pattern, atrial fibrillation.
heart , only surfaces , which blends with adjacent areas is the only clue. One should be able to recognise...
3. c. Sinus bradycardia is an expected rhythm disorder with an inferior-wall MI. The right coronary artery supplies the inferior wall of the left ventricle and, in most people, the sinoatrial (SA) and AV nodes as well.