ABSTRACT
To assess the exact cause and extent of transdermal glyceryl trinitrate (GTN)-induced allergic reactions, a study of continuous and intermittent use of GTN patches was conducted in 320 patients with New York Heart Association (NYHA) class II and III angina pectoris. Three commercially available GTN patch systems were used. Twenty-one patients (6.5%) developed cutaneous reactions. In 17 patients (5.3%), the reactions were confined to the area of application and were characterised as irritant reactions. Four patients (1.2%) developed both localised and remote from the area of application lesions and one patient developed a generalised anaphylactic reaction. The rate of discontinuation of therapy was 3.4%. The irritant skin reactions were mainly due to contaminants and additives. Changing to a different transdermal system reduced the incidence of local reactions--a particularly desirable effect in patients who respond well to GTN therapy.
Subject(s)
Drug Eruptions/etiology , Nitroglycerin/adverse effects , Adhesives/adverse effects , Administration, Cutaneous , Aged , Angina Pectoris/drug therapy , Dermatitis, Contact/etiology , Drug Administration Schedule , Female , Glycerol/adverse effects , Humans , Male , Middle Aged , Myocardial Ischemia/drug therapy , Nitroglycerin/administration & dosage , Patch Tests , Silicones/adverse effectsABSTRACT
Six women suffering from Wolff-Parkinson-White syndrome and who were previously asymptomatic or nearly asymptomatic, were followed prospectively during and after their subsequent pregnancies. Three women experienced several attacks of supraventricular tachycardia (SVT) for the first time and the rest experienced an increase in their attacks. It seems that there is an increased tendency for SVT in pregnancy. Increased adrenergic sensitivity by estrogens, increased plasma volume, stress, and anxiety during pregnancy may be some of the causative factors.
Subject(s)
Pregnancy Complications, Cardiovascular/physiopathology , Tachycardia, Supraventricular/diagnosis , Wolff-Parkinson-White Syndrome/physiopathology , Adult , Echocardiography , Electrocardiography/methods , Electrocardiography, Ambulatory , Female , Humans , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosis , Prospective Studies , Signal Processing, Computer-Assisted , Tachycardia, Supraventricular/etiology , Wolff-Parkinson-White Syndrome/diagnosisABSTRACT
To determine the effects of intravenous nitroglycerin on the velocities and excursions of the acutely ischemic myocardium, 20 open-chest dogs were studied by use of ultrasound. In 10 dogs with acute septal ischemia, the posterior wall excursion during contraction (B-C excursion), the mean systolic posterior wall velocity, and the posterior wall excursion remained unaltered. Nitroglycerin, however, increased all these parameters (P less than 0.01). In 10 dogs with acute posterior wall ischemia the B-C excursion (aneurysmal bulging) increased (P less than 0.01), but the mean systolic posterior wall velocity and posterior wall excursion decreased (P less than 0.01). Nitroglycerin increased even more the aneurysmal bulging (P less than 0.01) and the other parameters (P less than 0.01). Increased regional blood flow, reduced afterload, and mechanical pulling of the ischemic myocardium seem to be a possible mechanism. The measurements were obtained using the recently described method of the specific points.
