Rosh Emergency Medicine Practice Test

In a patient with inferior wall myocardial infarction and evidence of right ventricular infarction, intravenous fluid infusion is vital to ensure cardiovascular stability. Right ventricular infarction typically occurs in conjunction with inferior wall myocardial infarctions and can lead to significant hemodynamic compromise due to decreased filling pressures and a reduced cardiac output. Restoring adequate preload through fluid administration is essential because the right ventricle relies heavily on a sufficient volume of blood returning to it for optimal function, especially in the setting of ischemia. Without proper preload, the right ventricle cannot pump effectively, which can lead to hypotension and further cardiovascular instability. Administering beta-blockers in this context may not be advisable initially, as they can reduce heart rate and contractility, potentially worsening hypotension in a patient already compromised by right ventricular ischemia. Cardiac MRI, while beneficial in certain evaluations, is not an immediate intervention useful for stabilizing a patient in acute distress. Nitroglycerin can cause venodilation and reduce preload, which, although may alleviate some ischemic pain, could further compromise a patient with right ventricular involvement since it reduces venous return to the heart. Therefore, focusing on fluid resuscitation directly addresses the underlying issue of inadequate preload and helps in restoring