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L'administration orale de dinitrate d'isosorbide dans l'infarctus du myocarde non complique d'insuffisance cardiaque. Ses effets hémodynamiques

par Dereume, Georges ;Culotta, A.;Bernard, Roland
Référence La Revue de Medecine Interne, 2, 1, page (121-129)
Publication Publié, 1981

Article révisé par les pairs

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Résumé :

Isosorbide dinitrate (IDN) given orally in 10 patients with acute myocardial infarction without failure induced haemodynamic changes from the 10th minute. The changes were maximal at 30 minutes and regressed after 2 to 4 hours. A reduction in preload explained the fall in right heart pressures (pulmonary artery and capillary) and cardiac output. The slight reduction in afterload related to the effect of IDN was offset in our patients without heart failure by a sympathetic reaction probably secondary to the reduction in cardiac output, which would explain the increase in peripheral resistance and the stability of the systemic blood pressure. The absence of increase in heart rate would seem to indicate an incomplete sympathetic reaction. No cases of shock were observed after the oral administration of IDN.