14 Patients with acute myocardial infarction were given 0.3 mg sublingual nitroglycerin within the first 12 hr of their acute myocardial infarction. 5 Min after sublingual nitroglycerin mean arterial pressure fell 9 mmHg (1.2 kPa) and remained significantly reduced for 30 min. Pulmonary capillary wedge pressure fell from a mean control value of 17 to 12 mmHg (2.3 to 1.6 kPa) and also remained reduced for 30 min. Heart rate was significantly raised and stroke work index reduced at 5 min. Patients with a stroke work index of greater than 55 g m per m2 b.s.a. responded to nitroglycerin with a fall in both pulmonary capillary wedge pressure and stroke work index while in those with a stroke index of less than 55 9 m per m2 b.s.a. stroke work index did not fall concomitantly with the fall in pulmonary capillary wedge pressure. In one patient, nitroglycerin led to a precipitous fall in arterial pressure and recurrence of chest pain.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine