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[Clinical impact of the Bezold-Jarisch reflex in coronary arteriography]
Insights
Coronary arteriography can trigger the Bezold-Jarisch reflex, causing heart rate drops. Atropine pre-medication effectively prevents this reflex during the procedure.
Area of Science:
- Cardiology
- Physiology
- Pharmacology
Context:
- Coronary arteriography involves injecting contrast material into coronary arteries.
- The Bezold-Jarisch reflex is a cardiovascular reflex that can cause bradycardia and hypotension.
- Potential adverse effects of coronary arteriography require investigation.
Purpose:
- To determine if coronary arteriography induces the Bezold-Jarisch reflex.
- To assess the efficacy of atropine in preventing this reflex.
Summary:
- Nine patients received atropine before coronary arteriography (Group I), while nine did not (Group II).
- Heart rate was monitored before, during, and after intracoronary injections.
- Group I showed minimal heart rate changes, while Group II experienced significant decreases, indicating contrast injection triggers the reflex, which atropine prevents.
Impact:
- Demonstrates that radiologic contrast material injection during coronary arteriography can trigger the Bezold-Jarisch reflex.
- Highlights atropine as a potential prophylactic agent to mitigate this reflex and its associated bradycardia.
- Informs clinical practice regarding patient pre-medication for coronary arteriography.
Abstract:
To evaluate the role that coronary arteriography has in the induction of the Bezold-Jarisch reflex we study 9 patients (group I) to whom 1 mg. of atropine was administered 45 min. before the coronary arteriography and 9 patients (group II) without pre-medication. The heart rate was measured before, during and after each intracoronary injection. In group I there was no change in heart rate in 6 patients, in 3 cases the heart rate dropped to 15 beats/min. In group II the heart rate decreased in 8 cases. We conclude that the injection of radiologic contrast material in the coronary arteries triggers the Bezold-Jarisch reflex and that this reflex is prevented by the administration of atropine.