[Nitroglycerin in the therapy of coronary insufficiency and heart failure]

In the treatment of angina pectoris nitroglycerin is still the most important drug. Its mechanism of action is described in reference to the lowering of preload and afterload as well as to the question of redistribution of regional myocardial blood flow. It is shown that after oral administration of issosorbide dinitrate effects on myocardial ischemia and left ventricular filling pressure can be seen lasting over more than four hours. In the treatment of acute myocardial infarction and left ventricular failure nitroglycerin can be used with favourable results and without undesired side effects if the hemodynamic is carefully observed. Under these conditions the intravenous infusion seems the most appropriate way of administration.