Q. Why does JRCALC now advise giving GTN cautiously for STEMI patients and not recommend it as first line therapy for STEMI?
STEMI patients have an occluded artery and therefore dilating the coronary artery with the aim to improve blood flow and reduce pain, will not occur. It may however make the patient feel more unwell by dropping the blood pressure, particularly if the patient has been sweating significantly with their MI.
We are therefore not recommending routine use of GTN in STEMI (unlike NSTEMI) but if for example, it is being used to off load patients who are developing pulmonary oedema but with good blood pressure, it should be used cautiously.
We are therefore not recommending routine use of GTN in STEMI (unlike NSTEMI) but if for example, it is being used to off load patients who are developing pulmonary oedema but with good blood pressure, it should be used cautiously.