ST-elevation acute myocardial ischemia occurred after phenylephrine infusion in a patient with severe coronary artery disease and recent myocardial infarction. The subsequent administration of nitroglycerin led to a vasovagal response with symptomatic hypotension and bradycardia. During myocardial ischemia, heart rate variability and baroreflex sensitivity analysis described a marked activation of sympathetic drive and a severe impairment of baroreflex control. The nitroglycerin-induced hypotension-bradycardia was associated with complex changes of autonomic pattern characterized by subsequent phases of abrupt activation/deactivation of the two limbs of autonomic nervous system developing into a loss of neural control mechanisms
Autonomic Neural Changes During Acute Myocardial ischemia after Phenylephrine Infusion and Subsequent Nitroglycerin-Induced Hypotension and Bradycardia
Nollo, Giandomenico;
1999-01-01
Abstract
ST-elevation acute myocardial ischemia occurred after phenylephrine infusion in a patient with severe coronary artery disease and recent myocardial infarction. The subsequent administration of nitroglycerin led to a vasovagal response with symptomatic hypotension and bradycardia. During myocardial ischemia, heart rate variability and baroreflex sensitivity analysis described a marked activation of sympathetic drive and a severe impairment of baroreflex control. The nitroglycerin-induced hypotension-bradycardia was associated with complex changes of autonomic pattern characterized by subsequent phases of abrupt activation/deactivation of the two limbs of autonomic nervous system developing into a loss of neural control mechanismsI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
