Beneficial and adverse effects of atropine in patients with acute myocardial infarction.
The action of atropine on heart rate, prevention of arrhythmias, electrical activity and heart contractility was studied in 35 patients with acute myocardial infarction. Atropine had a favourable effect in 24 out of 27 patients with sinus bradycardia, and hypotension present in some cases was improved. Ventricular extrasystoles observed in 12 patients were suppressed within one hour after atropine administration. A--V block was well influenced in 9 of 16 cases. Nine patients with A--V block, of whom 8 with pump failure, presented arrhythmias after atropine. In 12 patients atropine determined a transient enhancing of the ST segment elevation, caused a persistent increase of the Q wave and altered the systolic time intervals by reducing contractility, with subsequent partial return to initial values. The data obtained justify the use of atropine for the improvement of sinus bradycardia, of arterial hypotension and of A--V block. During the effect of the drug there occurred electrical and contractility changes and, in some patients with pump failure, arrhythmias appeared. These observations demonstrate the necessity of monitoring the patients under atropine treatment and of using small doses, repeated if necessary.
D001146:Arrhythmia, Sinus / Q000188:drug therapy; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control; D001285:Atropine / Q000009:adverse effects* / Q000494:pharmacology; D001919:Bradycardia / Q000188:drug therapy; D004562:Electrocardiography; D006327:Heart Block / Q000188:drug therapy; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007702:Kinetocardiography; D009200:Myocardial Contraction / Q000187:drug effects; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*
D001285:Atropine