The results of this study seem to indicate clearly that nausea, retching and vomiting (induced by the subcutaneous injection of apomorphine) may cause in normal unanesthetized dogs cardiac irregularities, such as heart-blocks, cardiac arrests, ventricular and auricular ectopic beats. These are most likely to occur during retching. There were also changes in rate, nausea causing usually a tachycardia and retching a bradycardia. The intravenous injection of atropine almost completely inhibited the cardiac irregularities associated with nausea, retching and vomiting following the injection of apomorphine. The results indicate that during marked excitation of the vomiting center the cardio-inhibitory mechanism is affected, the degree to which it is affected depending upon its sensitivity. Icterus per se caused both the appearance and the disappearance of electrocardiographic abnormalities in a few instances. The changes in rate were variable, but the tendency was towards an increase. Slowing of the heart rate, however, may occur. Preexisting icterus increased the occurrence of the cardiac irregularities which are associated with the elicitation of nausea, retching, vomiting and pain by distention of the biliary passages. The irregularities following the injections of apomorphine could not be said to parallel closely the degree of icterus; but the changes due to distention of the biliary system did parallel the degree of icterus. This may have been due to the probable fact that apomorphine is a stronger stimulus. The results of the experiments on the icteric animals, we believe, indicate that icterus sensitizes the cardiovagal mechanism. Electrocardiographic abnormalities, such as extrasystoles, arrests, ectopic, ventricular, A-V blocks, etc., occurred in 10 per cent of the students while nauseated or retching during the swallowing of a stomach tube. No change in the rate was observed in one student. In the others there was an increase in rate which was dependent upon the ease with which the tube was swallowed. It is interesting to note that a bradycardia did not occur, whereas in dogs during retching bradycardia occurred very uniformly. In all experimental procedures, changes in the P-wave, the QRS complex and the T-wave occurred, none of the changes being characteristic.
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