Case 1:

JF is a 42-year old previously healthy farmer who presented with sudden onset central chest pain of one hour duration to the ED. The pain is associated with sweating and radiates to the left arm and jaw. The area of discomfort is about the size of the fist.

Ragavendra R. Baliga, M.D
Assistant Professor
Division of Cardiology
University Of Michigan

 

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Question 10 of 39:

Although this patient has an uncomplicated myocardial infarction and his oxygen saturation is >95%, oxygen should be administered for at least 24-48 hours.

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For patients without complications, it should be recalled that excess administration of oxygen can result in systemic vasoconstriction, and high flow rates can be harmful to patients with associated chronic obstructive pulmonary disease. However, when nitroglycerin is administered there is dilatation of the pulmonary vascular bed and increases in ventilation-perfusion abnormalities and therefore, it is reasonable to provide supplemental oxygen at least in the initial hours, to all patients having a suspected myocardial oxygen.

In the absence of compelling evidence for established benefit in uncomplicated cases and in view of its expense, there appears to be little justification for continuing its routine use beyond 2 to 3 hours.

 
 
 
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