Question
A 57-year-old man has an anterior MI. It is complicated by the development of heart failure. Nitroglycerin would be a useful first medication under which circumstances?
| A. |
severe pulmonary congestion, blood pressure 80 mm Hg systolic
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| B. |
clear lungs, blood pressure 120 mm Hg systolic
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| C. |
clear lungs, blood pressure 80 mm Hg systolic
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| D. |
moderate pulmonary congestion, blood pressure 130 mm Hg systolic
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Show Answer
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Correct Answer � D
Explanation
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Ans. (D)
Nitroglycerin is a vasodilatory drug used primarily to provide relief from anginal chest pain. It is currently FDA approved for the acute relief of an attack or acute prophylaxis of angina pectoris secondary to coronary artery disease. Off-label, non-FDA-approved uses include treatment for hypertensive urgency/emergency, coronary artery spasm, angina secondary to cocaine use, congestive heart failure (CHF), and chronic anal fissures.
Nitroglycerine is usually used in the setting of severe pulmonary congestion with adequate blood pressure. With significant hypotension, inotropic agents are generally administered before nitroglycerine.
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