TABLE 52-11 Treatment Strategy for Right Ventricular Ischemia/

Infarction

Maintain right ventricular preload

Volume loading (IV normal saline)
Avoid use of nitrates and diuretics
Maintain AV synchrony
AV sequential pacing for symptomatic high-degree
heart block unresponsive to atropine
Prompt cardioversion for hemodynamically significant
SVT
Inotropic support
Dobutamine (if cardiac output fails to increase after
volume loading)
Reduce right ventricular afterload with left ventricular
dysfunction
Intra-aortic balloon pump
Arterial vasodilators (sodium nitroprusside, hydralazine)
ACE inhibitors
Reperfusion
Thrombolytic agents
Primary PTCA
CABG (in selected patients with multi-vessel disease)

ABBREVIATIONS: IV = intravenous; AV = atrioventricular; SVT =

supraventricular tachycardia; ACE = angiotensin-converting enzyme; PTCA
= percutaneous transluminal coronary angioplasty; CABG = coronary artery
bypass graft.
SOURCE: Ryan et al.2 With permission.