| Rebound myocardial ischaemia following abrupt interruption of intravenous nitroglycerin infusion in patients with unstable angina at rest. | |
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MedLine Citation:
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PMID: 1904029 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Isolated observations prompted a prospective study of the possible occurrence of myocardial ischaemia following abrupt discontinuation of intravenous infusion of nitroglycerin in 46 consecutive patients with unstable angina. In 26 (55%, group 1), but not the remainder (45%, group 2), cessation of nitroglycerin produced in 10.3 +/- 5.8 (mean +/- SD) minutes ECG changes comparable with those of spontaneous angina without significant changes in heart rate and blood pressure. Reproducible results were observed in 18/20 patients in whom the test was repeated. In four patients with two positive tests, a third test failed to elicit ischaemia 15 min after sublingual administration of 5 mg isosorbide dinitrate. An ergonovine test performed in four other patients with a positive test produced similar ECG changes. Thus, acute interruption of intravenous nitroglycerin infusion in patients with unstable angina is often associated with acute myocardial ischaemia. The lack of preceding changes in heart rate and blood pressure and the similarities with the spontaneous episodes and with those produced by ergonovine, strongly suggest a rebound coronary vasoconstrictive phenomenon as the underlying mechanism. |
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Authors:
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J Figueras; R Lidon; J Cortadellas |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European heart journal Volume: 12 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 1991 Mar |
Date Detail:
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Created Date: 1991-07-09 Completed Date: 1991-07-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 405-11 Citation Subset: IM |
Affiliation:
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Unitat Coronaria, Hospital General Vall d'Hebron, Barcelona, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina, Unstable / drug therapy*, physiopathology Angiography Blood Pressure / physiology Cardiac Pacing, Artificial Coronary Disease / chemically induced*, diagnosis, physiopathology Drug Administration Schedule Electrocardiography Ergonovine / diagnostic use Heart Rate / physiology Humans Infusions, Intravenous Middle Aged Nitroglycerin / administration & dosage, adverse effects* Prospective Studies Reproducibility of Results Stroke Volume |
| Chemical | |
Reg. No./Substance:
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55-63-0/Nitroglycerin; 60-79-7/Ergonovine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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