Document Detail


Acute myocardial infarction: intracoronary application of nitroglycerin and streptokinase.
MedLine Citation:
PMID:  121799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In five patients with acute myocardial infarction, the effects of both intracoronary nitroglycerin (NTG) and subsequent intracoronary streptokinase application were evaluated. In addition, transluminal recanalization was performed in one of these patients. Injection of NTG into the infarct-related coronary artery resulted in improved distal filling of the subtotally occluded left circumflex artery in one patient, and in transient patency of the completely occluded right coronary artery in a second patient. In a third patient patency of the totally occluded left anterior descending artery (LAD) was achieved by transluminal recanalization with a guide wire. In a forth patient with occulsion of the LAD, there was no response to intracoronary NTG and mechanical recanalization was not attempted. Subsequent intracoronary infusion of streptokinase (1,000--2,000 U/min for 15--60 min) resulted in a further and long-term reduction of narrowing at the site of acute occlusion in patients I-III and in opening of the completely occluded LAD in patient IV. Improvement of lumen was paralleled by alleviation of symptoms. In a fifth patient, in whom the LAD was subtotally occluded, the degree of coronary obstruction could not be changed by intracoronary application of NTG or by lysis. In this patient, symptoms and ECG changes improved with reduction of pathologically elevated blood pressure values. The findings suggest that myocardial infarction had been caused by thrombotic occulsion in four patients, and that spasm of the infarct vessel could have been an additional factor in two of these patients. In the fifth patient, an increase of afterload in the presence of a subtotal lesion might have caused the critical imbalance between oxgen supply and demand, resulting in cell death.
Authors:
K P Rentrop; H Blanke; K R Karsch; V Wiegand; H Köstering; H Oster; K Leitz
Related Documents :
17692949 - Antioxidant status of south indian patients undergoing coronary artery bypass graft sur...
2191849 - Intravenous streptokinase. a reappraisal of its therapeutic use in acute myocardial inf...
3711489 - Elevated serum d dimer: a degradation product of cross-linked fibrin (xdp) after intrav...
3511819 - Rapid lysis of coronary artery thrombi with anisoylated plasminogen: streptokinase acti...
8694009 - Magnesium in acute myocardial infarction: overview of available evidence.
6404289 - Reduction of infarct size in patients with inferior infarction with intravenous glycery...
21352349 - Cardiac arrhythmia induced by interferon beta-1a.
8288449 - The use of central nervous system manifestations in the early detection of digitalis to...
9423979 - Variable effects of cardiomyoplasty on left ventricular function.
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  2     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1979 Oct 
Date Detail:
Created Date:  1980-12-16     Completed Date:  1980-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  354-63     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass
Coronary Vessels
Female
Heart Catheterization
Humans
Injections, Intra-Arterial
Male
Middle Aged
Myocardial Infarction / drug therapy*,  therapy
Nitroglycerin / administration & dosage*
Streptokinase / administration & dosage*
Chemical
Reg. No./Substance:
55-63-0/Nitroglycerin; EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Influence of high hydrostatic pressure on the formation of keto and amino acids by a barotolerant st...
Next Document:  Parenteral nutrition with essential amino acids in pretransplantation anephrics.