Document Detail

Acute myocardial infarction: intracoronary application of nitroglycerin and streptokinase.
MedLine Citation:
PMID:  121799     Owner:  NLM     Status:  MEDLINE    
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.
K P Rentrop; H Blanke; K R Karsch; V Wiegand; H Köstering; H Oster; K Leitz
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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    
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MeSH Terms
Coronary Artery Bypass
Coronary Vessels
Heart Catheterization
Injections, Intra-Arterial
Middle Aged
Myocardial Infarction / drug therapy*,  therapy
Nitroglycerin / administration & dosage*
Streptokinase / administration & dosage*
Reg. No./Substance:
55-63-0/Nitroglycerin; EC 3.4.-/Streptokinase

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

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