You have a patient with an inferior STEMI. Their BP is slightly elevated, and they’re in clear discomfort. You order sublingual nitroglycerin, but before the nurse administers it, your colleague chimes in: "You haven’t done a right-sided ECG—what if this is an RV infarct? You don’t want to tank their pressure!" You pause. This teaching has been drilled into every emergency physician’s brain—but is it actually true? Does the evidence really support withholding nitrates in RV MI?
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Where Did This Teaching Come From?
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Wilkinson-Stokes et al - 2022 Systematic Review & Meta-Analysis
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What to Consider Before Changing Practice
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The Bottom Line
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