The Correct Answer is C!

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A patient presents with severe heart failure and BP 90/60 mmHg with underlying severe aortic stenosis and EF 33%. His cardiac index is 1.8 l/min/m².

What is the drug that will optimally improve his myocardial performance?

  1. Phenylephrine
  2. High dose dopamine (15 μg/kg/min)
  3. Nitroprusside
  4. Norepinephrine

Answer Rationale:

This patient has a high peripheral vascular resistance despite his low systemic pressure. All vasoconstrictors will decrease myocardial performance, which will negate the effect of the added B1 effect with high dose dopamine and norepinephrine.

1.  Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.