[Behavior of ACTH and cortisol in acute myocardial infarct].

In 30 patients with acute myocardial infarction in 4-hour intervals the temporary course of the ACTH and cortisol in the plasma was pursued up to the 60th hour. Here 3 different patterns of behaviour were found. In group 1 (11 patients) normal ACTH and cortisol values are present during the period of examination. In group 2 (13 patients) ACTH in increased at admission to hospital, and a decrease of the values to the normal takes place after the beginning of the infarction within 4 to 8 hours, whereas the plasma cortisol remains clearly increased. Increased ACTH and cortisol values during the whole period were measured in group 3 (6 patients). The different hormone constellations found are possibly the expression of a different reaction behaviour of the adrenocortical system in acute myocardial infarction. There is a weak positive correlation between the creatine kinase and the plasma cortisol. The size and the duration of the increase of ACTH and cortisol seems to be connected with the degree of severity of the acute myocardial infarction. An increase of ACTH and cortisol for a longer time is to be regarded as unfavourable for the course of the acute myocardial infarction, while uncomplicated courses are connected with normal ACTH and cortisol in the plasma.