Air Methods Critical Care Practice Exam 2025 - Free Critical Care Practice Questions and Study Guide

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Which treatment can be useful in systolic dysfunction but harmful in diastolic dysfunction?

β-blockers

Angiotensin-converting enzyme inhibitors

Aldosterone antagonists

Vasodilators

Vasodilators can be beneficial in managing systolic dysfunction, particularly in cases of heart failure where reduced contractility is present. By decreasing systemic vascular resistance, vasodilators improve the heart's ability to pump blood and can lead to better cardiac output. They can alleviate symptoms by reducing preload and afterload, which is critical when the heart is struggling to contract effectively.

In contrast, diastolic dysfunction occurs when the heart's ability to relax and fill with blood during the diastolic phase is impaired. In this scenario, the use of vasodilators can exacerbate the condition. Since diastolic dysfunction often involves issues with ventricle stiffness and impaired filling, relieving the pressure through vasodilation can lead to insufficient filling of the ventricles, causing reduced stroke volume and further complicating the patient's status.

Understanding the underlying mechanism of heart failure—systolic versus diastolic—is essential for selecting appropriate treatments, making it clear why vasodilators would be advantageous in systolic conditions and potentially detrimental in diastolic ones.

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