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Seven episodes of simultaneous severe systemic arterial hypotension and absolute or relative bradycardia were observed in five patients receiving either sublingual nitroglycerin (two patients) or intravenous nitroglycerin (three patients) within the first 24 hours of onset of symptoms of acute myocardial infarction. Left ventricular filling pressure, measured as pulmonary artery diastolic pressure, decreased simultaneously in all four patients in whom pulmonary artery pressures were monitored. No initial increase in heart rate was observed in any of the five patients prior to the development of bradycardia. Possible mechanisms producing simultaneous bradycardia and hypotension during nitroglycerin administration are considered. The patient studies emphasize the importance of careful hemodynamic monitoring during administration of sublingual or intravenous nitroglycerin to patients with acute myocardial infarction.
P C Come, and
B Pitt
February 1980,
Chest,
P C Come, and
B Pitt
January 1977,
Giornale italiano di cardiologia,
P C Come, and
B Pitt
February 1973,
Circulation,
P C Come, and
B Pitt
February 1982,
Archives of internal medicine,
P C Come, and
B Pitt
July 1981,
Archives of internal medicine,
P C Come, and
B Pitt
August 1989,
The American journal of cardiology,
P C Come, and
B Pitt
June 1968,
American heart journal,
P C Come, and
B Pitt
May 1966,
British heart journal,
P C Come, and
B Pitt
January 1999,
Giornale italiano di cardiologia,
P C Come, and
B Pitt
January 1981,
Cardiology,
