Effect of metaraminol during acute inferior wall myocardial infarction accompanied by hypotension: Preliminary study

Alex Sagie, Samuel Sclarovsky*, Eliezer Klainman, Boris Strasberg, Eldad Rechavia, Aviv Mager, Jairo Kusniec, Jacob Agmon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

This study was designed to evaluate the effects of metaraminol (Aramine) in six patients with evolving acute inferior wall myocardial infarction accompanied by hypotension and warm limbs. There were 16 episodes of acute inferior wall ischemia, and the response to therapy was judged by evaluating blood pressure and ST segment and T wave abnormalities. Three patients received intravenous isosorbide dinitrate and two received streptokinase as the initial therapy. The mean ST segment elevation was significantly reduced (from 4.94 ± 1 to 0.5 ± 0.7 [p < 0.0001]) after metaraminol infusion was initiated. The average T wave height also decreased (from 6.8 ± 2 to −1.3 ± 2.5 mm [p < 0.0005]). The average heart rate decreased from 82 ± 11 to 69 ± 9 beats/min (p < 0.05) and the mean arterial blood pressure increased from 81 ± 12 mm Hg before metaraminol treatment to 126 ± 8 mm Hg after treatment. All these changes occurred within a few minutes after metaraminol therapy was instituted. In 12 episodes, accelerated idioventricular rhythm appeared concomitantly with the resolution of ST segment elevation. Coronary angiography performed between 4 and 10 days after admission demonstrated significant obstruction in all infarct-related arteries, but none was totally occluded. Left ventricular function was normal in three patients and slightly hypokinetic in the inferior wall in two. These results indicate that in a selected group of patients with acute inferior myocardial infarction, metaraminol administration (in certain hemodynamic circumstances) can alleviate acute ischemia within a few minutes and thereby reduce ischemic injury.

Original languageEnglish
Pages (from-to)1139-1144
Number of pages6
JournalJournal of the American College of Cardiology
Volume10
Issue number5
DOIs
StatePublished - 1987

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