[Glucocorticoid functional characteristics of the adrenals in the terminal complications of acute myocardial infarct].

A follow-up study in the blood of the total, free and bound 11-oxycorticosteroids (11-OCS) and reserve binding capability of transcortin (RBCT) in 246 patients with acute myocardial infarction, complicated in 127 with cardiogenic shock, in 62 by ventricular fibrillation and in 57 by cardiac rupture was undertaken. In patients with acute myocardial infarction there was statistically reliable increased activation of glucocorticoid function of the adrenals with simultaneous marked drop of RBCT as compared with patients who had uncomplicated myocardial infarction. The greatest changes were found in patients with true cardiogenic shock and shock with cardiac rupture. Enhanced level of 11-OCS is retained for a long time in cardiogenic shock and ventricular fibrillation with lethal outcome. When the result is favourable there is a gradual decrease of glucocorticoids in the blood and a rise of RBCT.