Intravenous nitroglycerin in acute myocardial infarction

The American Journal of Medicine
R Roberts

Abstract

Until recently, the use of nitroglycerin in patients with acute myocardial infarction has been contraindicated primarily because of possible hypotension or tachycardia which, with sublingual or oral preparations, would be difficult to control. The introduction of intravenous nitroglycerin and its use during experimentally induced infarction paved the way for its use in patients with acute myocardial ischemia. It was shown that nitroglycerin, administered intravenously during experimentally induced coronary artery occlusion, redistributed flow to the subendocardium of the ischemic area while it maintained flow to the normal areas and was associated with decreased S-T segment elevation. Preliminary studies in patients with acute infarction have confirmed the beneficial effect of intravenous nitroglycerin on S-T segment elevation, and a subsequent study in 31 patients with acute infarction showed a decrease in infarct size with improved hemodynamics. In a more recent randomized prospective study in 85 patients with acute myocardial infarction, we found that intravenous nitroglycerin was associated with a decrease in infarct size in patients with inferior infarction (36 percent reduction, p less than 0.05) but that it had no effect...Continue Reading

References

Oct 1, 1975·British Heart Journal·S B KnoebelM J Mihalick
Nov 1, 1975·British Heart Journal·R RobertsB E Sobel
Dec 1, 1978·The American Journal of Cardiology·A S MostR W Millard
Jul 1, 1979·Current Problems in Cardiology·C R ContiR C Curry
Jan 1, 1975·Circulation·J T FlahertyB Pitt
Oct 1, 1976·Circulation·H A Fozzard, D S DasGupta
Nov 1, 1975·Circulation·R RobertsB E Sobel
May 1, 1968·Circulation Research·W M Fam, M McGregor
Oct 1, 1982·Circulation·M McGregor

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Citations

Jan 1, 1985·European Journal of Clinical Pharmacology·P A Cossum, M S Roberts
Aug 1, 1988·American Heart Journal·W M BreisblattL J Spaccavento
Jun 22, 1984·The American Journal of Medicine·J B YoungR Roberts
Jun 22, 1984·The American Journal of Medicine·J Abrams
Jun 22, 1984·The American Journal of Medicine·C J PepineJ S Gelman
Feb 1, 1984·International Journal of Cardiology·G D Curfman
Oct 1, 1989·Toxicology and Industrial Health·D MukerjeeW Karmaus
Jan 1, 1988·Catheterization and Cardiovascular Diagnosis·M L Carr
Jan 1, 1986·Acta Pharmacologica Et Toxicologica·B W Johansson

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