What is the mainstay treatment for a patient with an Inferior Myocardial Infarction?

• A. IV fluid bolus
• B. Nitrates
• C. Morphine sulfate
• D. Dopamine

Answer: (B)

Relief of ischemia by reducing the heart’s workload is the cornerstone of managing an inferior myocardial infarction. Nitrates do this by relaxing venous smooth muscle, which lowers preload and myocardial wall tension, thereby decreasing oxygen demand and often easing chest pain. This preload reduction helps improve subendocardial perfusion and overall ischemia. In most inferior MIs, nitrates are a central, frontline therapy provided the patient’s blood pressure is stable and there’s no suspicion of right ventricular involvement. If right ventricular infarction is suspected, nitrates can worsen hypotension by further decreasing preload, so fluids and other strategies may be preferred in that scenario. The other options don’t address ischemia and preload in the same direct way: a fluid bolus is generally reserved for suspected RV infarction to maintain preload, morphine is an adjunct for pain relief, and dopamine is used mainly for hypotension when other measures aren’t sufficient.