NREMT Paramedic Practice

What is the expected hemodynamic response in an anterior myocardial infarction (MI)?

1. Increased heart rate and low blood pressure

2. Sympathetic response with normal or high blood pressure

3. Parasympathetic response with low blood pressure

4. Bradycardia with decreased blood pressure

The correct answer is: Sympathetic response with normal or high blood pressure

In the context of an anterior myocardial infarction, the expected hemodynamic response typically includes a sympathetic response characterized by normal or elevated blood pressure. During an anterior MI, there is often activation of the sympathetic nervous system due to stress and the body’s need to compensate for reduced cardiac output. This is reflected in the release of catecholamines, which increase heart rate and contractility to maintain perfusion to vital organs. In many cases, particularly early in the presentation of an MI, patients may experience maintained or even increased blood pressure due to this sympathetic stimulation. The body attempts to manage the decreased efficiency of the heart by increasing systemic vascular resistance and heart rate, which can lead to a stable or elevated blood pressure reading. On the other hand, bradycardia and significant hypotension are less common findings in a straightforward anterior MI, although they can occur in specific circumstances or with certain complications. Thus, a sympathetic response that results in normal or elevated blood pressure aligns with the physiological changes expected during an anterior myocardial infarction.