skip to main content

Inferior STEMI with right ventricular involvement — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

HardMedical EmergenciesInferior STEMI with right ventricular involvementDipIMC

A 64-year-old man has central chest pain and diaphoresis. ECG shows inferior ST elevation with ST elevation in V4R, pulse 54/min and systolic blood pressure 86 mmHg after he used sildenafil last night. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: CGive aspirin and pre-alert PPCI, avoiding nitrates

Right ventricular infarction with hypotension and recent sildenafil makes nitrates hazardous. Aspirin, analgesia, ECG transmission/pre-alert and PPCI pathway are appropriate. Bradycardia does not make the presentation benign in an inferior STEMI.

Reference: JRCALC Guidelines; NICE acute coronary syndrome guidance