The Effects of Nitric Oxide for Inhalation in Right Ventricular Infarction Patients

Inclusion Criteria: * Acute inferior mycardial infarction (defined as an episode of chest pain lasting \>30 minutes and electrocardiographic evidence of 1 mm or greater ST elevation in inferior leads) within the past 72 hours. * Invasive hemodynamic evidence of hemodynamically-significant RV dysfunction, defined as the presence of all the following: systemic venous congestion (mean RA pressure \> 10mmHg), the ratio of RA/PCW pressure 0.75 or greater, a low cardiac output as determined by Fick or Thermodilution (TD) technique (cardiac index \< 2.5 l/min/m2), systolic systemic arterial blood pressure of 90mmHg or less or requiring vasopressor or mechanical support to maintain systolic pressure \> 90mmHg. Patients with a PCWP of 14mmHg or less should receive intravascular volume repletion until their PCWP is \> 14mmHg. * Coronary angiography revealing either an occlusion of the RCA proximal to any RV marginal branch or evidence of diminished flow to RV marginal branches of the RCA. * If patient undergoes coronary revascularization, there must be evidence of unsuccessful right ventricular reperfusion (lack of restoration of TIMI grade III flow in the distal RCA and \> 1mm RV marginal branches) or evidence of hemodynamically significant RVI must persist for greater than 1 hour after successful revascularization. * Age 18 years or greater Exclusion Criteria: * PCW 25mmHg or greater or mechanical complications of myocardial infarction requiring surgical correction. * Severe LV systolic dysfunction as determined by the principal investigator. Unprotected left main coronary stenosis \> 50%. * Pulmonary infiltrates consistent with pulonary edema on chest X-ray (if chest X-ray is clinically indicated). * Evidence of shock-related end-organ damage, including creatinine 3.0 or greater, metabolic acidosis (pH 7.1 or less) and not corrected by 100 ml NaHCO3 (1mEq/ml), disseminated intravascular coagulation, or clinical evidence of diffuse brain injury. * Previous history of severe pericardial, congenital, or valvular heart disease. * Refractory hemodynamically significant arrhythmia. * Presence of pneumonia, adult respiratory distress syndrome, or sepsis. * Prior history of pulmonary disease requiring chronic oxygen therapy. * Pregnancy * Use of investigational drugs or device within the 30 days prior to enrollment to the study. * Uncontrolled active bleeding.