Can nitroglycerin convert effort-induced angina in men into silent myocardial ischemia?

Can nitroglycerin convert effort-induced angina in men into silent myocardial ischemia?

The relief of anginal pain with nitroglycerin may not correspond to the disappearance of ischemia. To evaluate me possible lack of the elimination of ischemia with sublingual nitroglycerin, we studied 25 male patients with stable angina pectoris who underwent exercise stress testing with recording o...

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Bibliographic Details
Published in:The American journal of cardiology Vol. 76; no. 5; pp. 337 - 339
Main Authors: Khosla, Sandeep, Coutinho, Newton B., Megellas, Michelle M., Mukherjee, Debu, Somberg, John C.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 15-08-1995
Elsevier
Elsevier Limited
Subjects:
Administration, Sublingual
Aged
Angina pectoris
Angina Pectoris - drug therapy
Biological and medical sciences
Blood Pressure
Cardiology. Vascular system
Cardiovascular disease
Coronary heart disease
Data Interpretation, Statistical
Drug therapy
Electrocardiography
Exercise Test
Heart
Heart Rate
Humans
Male
Medical sciences
Men
Middle Aged
Myocardial Ischemia - diagnosis
Nitroglycerin - administration & dosage
Nitroglycerin - pharmacology
Time Factors
Vascular disease
Human
Chemotherapy
Nitroglycerine
Treatment
Ischemia
Sublingual administration
Myocardium
Cardiovascular disease
Asymptomatic
Coronary heart disease
Myocardial disease
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Summary:The relief of anginal pain with nitroglycerin may not correspond to the disappearance of ischemia. To evaluate me possible lack of the elimination of ischemia with sublingual nitroglycerin, we studied 25 male patients with stable angina pectoris who underwent exercise stress testing with recording of blood pressure, pulse, and ST-segment displacement. The stress test was repealed 30 minutes after administration of 0.4 mg of sublingual nitroglycerin. All 25 patients had angina and ischemic ST-segment changes in the first stress test. On repeat stress testing, 15 patients had angina and ST-segment changes, 2 patients had angina but no ST-segment changes, and 4 patients had no ST-segment changes and no angina. Four patients, however, had no angina but persistent ischemic ST-segment changes suggesting that angina was converted into silent ischemia. The mean exercise duration was 311 ± 66 seconds before and 421 ± 81 seconds after the nitroglycerin test. Peak heart rate and systolic blood pressure before the nitroglycerin stress test were 109 ± 18 and 155 ± 23 mm Hg; in the repeat stress test, they increased to 123 ± 21 and 162 ± 20 mm Hg, respectively.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(99)80096-4