Metaraminol induced reversal of acute myocardial ischemia associated with hypotension and refractory to intravenous nitroglycerin

Figueras J.; Lidon R. M.; Cortadellas J.

In seven patients, acute myocardial ischaemia associated with STR segment elevation (5.7 .+-. 1.6 mm, mean .+-. SEM) and arterial hypotension (systolic blood pressure 57 .+-. 9 mmHg), was reversed within 9 min (mean time to reversal 274 .+-. 45 s) by the intravenous administration of metareminol (1.9 .+-. 0.2 mg). This myocardial ischemia was refractory to nitroglycerin and, in every patient, the increases in blood pressure induced by metaraminol (to a mean systolic blood pressure of 191 .+-. 22 mmHg) preceded reversal of the ECG changes. It is suggested that, in some patients, transmural myocardial ischemia of recent onset associated with hypotension can be reversed by transiently increasing blood pressure with metaraminol.