Abstract
SummaryCardiotonic glucosides are indicated in recent myocardial infarction complicated by paroxystic auricular tachycardia, by auricular flutter or fibrillation, by intense sinusal tachycardia and by heart failure, i.e. in 15 to 50 % of all cases. These drugs are of no use in the common forms of recent myocardial infarct, and definitely contra-indicated in infarcts complicated by auriculo-ventricular block. Although they should be managed cautiously, premature beats and ventricular tachycardia are not absolute contra-indications to digitalis.More than slight differences in action or absorption, it is the physician’s own experience which determines the type of glucoside to be used. The oral route should be preferred if a compound with regular intestinal absorption, such as digitoxin, is administered. Initial doses are adjusted to heart rate and severity of heart failure. Moderate doses (0.2 to 0,3 mg Digitaline daily) arc generally sufficient, but recent myocardial infarction should not preclude larger dosage if this is necessary.The effectiveness of cardiotonic glucosides in recent coronary thrombosis is demonstrated by decrease in ventricular rate (and frequent restoration of sinusal rhythm in cases with ectopic rhythm) in 90 % of the cases, and by improvement or disappearance of signs of heart failure in 75 % of the cases. Failures of digitalis therapy are related to the type and grade of heart failure, for as heart failure itself, they parallel the magnitude of the myocardial injuries.The frequent severity of myocardial lesions thus explains most of the accidents observed during therapy. For the same degree of heart failure, the accidents observed during digitalization after coronary thrombosis are not more frequent or more severe than in heart failure of other aetiologies. To decrease the occurrence and severity of these accidents, anticoagulants should be added to digitalis treatment, as well as diuretic drugs, with addition of K if necessary. Such patients should be submitted to careful clinical and electrical supervision. If nausea, vomiting, bigeminal or polymorphous ventricular premature beats, or any disturbance in auriculo-ventricular conduction supervene, digitalis administration should be immediately interrupted, and appropriate measures should be eventually instituted.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.