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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bradycardia and hypotension following reperfusion with streptokinase (Bezold-Jarisch reflex): A sign of coronary thrombolysis and myocardial salvage
American Heart Journal, Volume 112, No. 3, Year 1986
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Description
Acute myocardial infarction, particularly of the inferior wall, is frequently associated with bradycardia and hypotension. This study reports the occurrence of transient bradycardia hypotension (TBH) (Bezold-Jarisch reflex) following thrombolytic therapy with intravenous streptokinase. Of the 52 patients, 42 had successful reperfusion, and 12 of the latter developed reflex TBH. The Bezold-Jarisch reflex occurred in 10 of 24 patients with inferior wall acute myocardial infarction and in 2 of 28 patients with anterior wall infarction (p < 0.05). The reflex was associated with significantly more non-Q wave infarctions (p < 0.05) and also with reduction of left ventricular damage, as evidenced by a lower QRS score (4 ± 3.8 vs 8.9 ± 5.6, p < 0.01) and a higher ejection fraction (61 ± 13% vs 49 ± 16%, p < 0.05). Patients with inferior wall acute myocardial infarction were divided into those with TBH (10 patients) and those without TBH (14 patients). TBH was associated with a significantly higher infarct-related regional ejection fraction (60 ± 19% vs 35 ± 18%, p < 0.05). The results of this study confirm previous findings that reperfusion of the inferoposterior myocardium is capable of stimulating reflex TBH. Furthermore, TBH is associated with patency of infarct-related coronary arteries and myocardial salvage. © 1986.
Authors & Co-Authors
Koren, Gideon
Israel, Jerusalem
Hadassah University Medical Centre
Gotsman, Mervyn Samuel
Israel, Jerusalem
Hadassah University Medical Centre
Statistics
Citations: 44
Authors: 2
Affiliations: 1
Identifiers
Doi:
10.1016/0002-8703(86)90508-9
ISSN:
00028703