Symposium on Coronary Dilator Drugs

Abstract

History, physical findings, and laboratory findings of a patient with classical angina pectoris due to coronary artery disease are presented. Graphic recording of pulsations of the chest wall (the kinetocardiogram) in the region of the apex reveals normal configuration at rest and a systolic bulge (a transient ventricular aneurysm), when angina is produced by exercise. The bulge is prevented by previous medication with sublingual nitroglycerin. Pre-medication with 2% nitroglycerin ointment prevents formation of the aneurysms for about 3 hours. Use of the ecg and the history in diagnosis of angina is discussed. The pharmacology of nitrites, aminophyllin, and papaverine is described briefly. It is concluded that nitroglycerin is the most effective coronary vasodilator, and that nitroglycerin ointment has an effective duration of action of 3 or 4 hours.