Buckley R, Roberts R
Department of Emergency Medicine, Cook County Hospital, Chicago, IL 60612.
Am J Emerg Med. 1993 May;11(3):253-5. doi: 10.1016/0735-6757(93)90140-7.
A case of severe bradycardia with junctional escape immediately following sublingual nitroglycerin is described. Bradycardia is a rare, but well-documented, complication of nitroglycerin and is often reported in the setting of myocardial ischemia or infarction. This particular case reported was complicated by the presence of an angiographically documented congenital coronary anomaly, but did not have either electrocardiographic or enzymatic evidence of ischemia or infarction during this event. Previously reported cases were reviewed, as well as potential mechanisms for this phenomenon. All cases reported to date were easily corrected with passive leg elevation or atropine.
本文描述了1例舌下含服硝酸甘油后立即出现严重心动过缓并伴有交界性逸搏的病例。心动过缓是硝酸甘油一种罕见但有充分文献记载的并发症，常报道于心肌缺血或梗死的情况下。本报告的这一特殊病例因存在血管造影证实的先天性冠状动脉异常而复杂化，但在此事件期间没有心电图或酶学证据表明存在缺血或梗死。回顾了先前报道的病例以及这种现象的潜在机制。迄今为止报道的所有病例通过被动抬腿或阿托品均可轻松纠正。
