title: Administration of atropine in the setting of acute myocardial infarction: potentiation of the ischemic process?
abstract: Atropine has also been suggested to potentially worsen the ischemic situation in patients who are in the midst of acute coronary ischemia. We report the case of a female patient with ischemic chest pain and third degree atrioventricular block who developed acute myocardial infarction (AMI) immediately after atropine administration. The use of atropine in this instance remains a reasonable option and should be strongly considered-despite this apparent complication. Undoubtedly in some cases, acute ischemia is intensified by hypoperfusion attributable to vagally mediated bradyarrhythmia; atropine is the antidote for such situations. An awareness of this potential adverse reaction coupled with a prudent selection of candidates for atropine therapy will show the risk/benefit ratio in each individual patient and, therefore, guide the clinician.
authors.affiliation: Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22906-0114, USA. wb4z@hscmail.mcc.virginia.edu
authors.forename: W J
authors.initials: WJ
authors.lastname: Brady
authors.forename: A D
authors.initials: AD
authors.lastname: Perron
mesh_terms: D000208:Acute Disease; D001285:Atropine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced*; D017202:Myocardial Ischemia / Q000150:complications* / Q000188:drug therapy*; D010276:Parasympatholytics / Q000009:adverse effects*
chemical_list: D010276:Parasympatholytics; D001285:Atropine