[Hemodynamic effect of skin applications of a nitroglycerin ointment in acute myocardial infarct].

The hemodynamic effect of the skin nitroglycerin ointment was studied in 16 patients with coronary disease (12 with acute myocardial infarction, and 4 with nonstable angina pectoris). All the patients were subject to catheterization of the pulmonary artery to determine the end diastolic pressure (EDPPA) and cardiac output with the method of thermal dilution. When the initial EDPPA was more than 18 mm Hg it decreased by 34%, the systolic arterial pressure decreased by 11%, the cardiac index (CI) being raised by 23%, after application of 1.5-3 inches of the ointment. The hemodynamic shifts persisted during 4h. In patients with normal EDPPA, lowering of this parameter by 40% and of CI by 19% was recorded. The heart rate in both the groups was not significantly altered. The nitroglycerin ointment did not induce unfavourable hemodynamic shifts in patients with no signs of cardiac failure. In those with myocardial infarction, complicated by circulatory insufficiency, the ointment improved the functional state of the left ventricle.