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Morphine decreases pre-load and after-load and because the Inferior wall is effected the right ventricle is effected. If you do not have enough blood entering the right ventricle when the area is necrotic to begin with you will not be pumping enough blood to perfuse sufficiently. In addition the decreased after-load in in conjunction with the decreased blood pressure caused by the failure of the right ventricle there will not be enough "back-flow" in the cardiac vascular system. In summation if can cause bottoming out of a patient's blood pressure and further cardiac hypo-perfusion. In some cases it has been shown to work if a normal saline or ringers lactate bolus is infused prior to morphine administration.

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Q: Why will you not give morphine in inferior wall myocardial infarction?
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