Case against routine use of glyceryl trinitrate before coronary angiography.
نویسندگان
چکیده
to the degree of coronary narrowing, 47 consecutive chest pain patients were studied without premedication by analysing selective coronary angiograms before and after glyceryl trinitrate. Proximal coronary diameters were measured in superimposed frames with callipers. Lumen diameter increased after glyceryl trinitrate 15 ± 2 per cent in the left main, 18 ± 2 per cent in the left anterior descending, 16 + 2 per cent in the circumflex, and 17 ± 2 per cent in the right coronary arteries (all P < 0.01). One hundred and nineteen coronary artery narrowings of < 90 per cent were measured (narrowings > 90 per cent were excluded because ofmeasurement inaccuracy). Of 81 narrowings < 50 per cent, 24 became > 50 per cent because of dilatation of the adjacent region. However, the diameter of the narrowed segment also changed significantly after glyceryl trinitrate, increasing in 28 and decreasing in 3. Of the 28 obstructions which dilated after glyceryl trinitrate, 4 were clinical and angiographic examples of coronary arterial spasm. In 4 other coronary arteries with only outline irregularities before glyceryl trinitrate a localised narrowing (25 to 50%) was seen after glyceryl trinitrate as the proximal artery dilated. We concluded that the routine use of glyceryl trinitrate before coronary angiography alters the measured degree of coronary artery narrowing and obscures the angiographic
منابع مشابه
Relief by intracoronary glyceryl trinitrate of coronary artery spasm resistant to sublingual route of administration.
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ورودعنوان ژورنال:
- British heart journal
دوره 40 9 شماره
صفحات -
تاریخ انتشار 1978