Levodopa therapy of patients with Parkinsonism and heart disease

Forty patients with Parkinsonism and heart disease were studied before and during the administration of levodopa. Patients with increasing angina, myocardial infarction within the previous year, pre-existing severe postural hypotension, or transient cerebral ischaemia were excluded. Thirty-eight patients showed no adverse effects; angina improved in one patient but later worsened; one patient died of myocardial infarction after a severe gastrointestinal haemorrhage. Therapy with levodopa appears to pose little increased hazard to patients with most forms of heart disease. Inpatient monitoring is recommended at the beginning of therapy, and antiarrhythmic agents should be used when required.