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. 1977 Feb;39(2):168–172. doi: 10.1136/hrt.39.2.168

Circulatory reflexes in myocardial infarction.

B J Kirby
PMCID: PMC483211  PMID: 836730

Abstract

The Valsalva manoeuvre was used to examine circulatory reflexes in 22 patients with acute myocardial infarction. Four patients had the 'square wave' response of cardiac failure and two responded normally to the manoeuvre. In the remaining 18 patients there was a 20 per cent or more fall in pulse pressure during the manoeuvre, but no ensuing rise in diastolic pressure, implying impairment of vasoconstriction. This impairment cannot be explained by acidosis, hypocapnia, or arterial hypoxaemia but may be explained by reflex inhibition of vasoconstriction. This abnormal response has important implications when transporting patients; furthermore, it could explain the rapid deterioration sometimes seen in patients with arrhythmias.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brown A. M. Excitation of afferent cardiac sympathetic nerve fibres during myocardial ischaemia. J Physiol. 1967 May;190(1):35–53. doi: 10.1113/jphysiol.1967.sp008191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. COSTANTIN L. Extracardiac factors contributing to hypotension during coronary occlusion. Am J Cardiol. 1963 Feb;11:205–217. doi: 10.1016/0002-9149(63)90062-6. [DOI] [PubMed] [Google Scholar]
  3. ELISBERG E. I. HEART RATE RESPONSE TO THE VALSALVA MANEUVER AS A TEST OF CIRCULATORY INTEGRITY. JAMA. 1963 Oct 19;186:200–205. doi: 10.1001/jama.1963.03710030040006. [DOI] [PubMed] [Google Scholar]
  4. Gebber G. L., Snyder D. W. Hypothalamic control of baroreceptor reflexes. Am J Physiol. 1970 Jan;218(1):124–131. doi: 10.1152/ajplegacy.1970.218.1.124. [DOI] [PubMed] [Google Scholar]
  5. Gribbin B., Pickering T. G., Sleight P., Peto R. Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res. 1971 Oct;29(4):424–431. doi: 10.1161/01.res.29.4.424. [DOI] [PubMed] [Google Scholar]
  6. Gross M. Circulatory reflexes in cerebral ischaemia involving different vascular territories. Clin Sci. 1970 Apr;38(4):491–502. doi: 10.1042/cs0380491. [DOI] [PubMed] [Google Scholar]
  7. HIRSCH E. F., BORGHARD-ERDLE A. M. The innervation of the human heart. I. The coronary arteries and the myocardium. Arch Pathol. 1961 Apr;71:384–407. [PubMed] [Google Scholar]
  8. Kolatat T., Ascanio G., Tallarida R. J., Oppenheimer M. J. Action potentials in the sensory vagus at the time of coronary infarction. Am J Physiol. 1967 Jul;213(1):71–78. doi: 10.1152/ajplegacy.1967.213.1.71. [DOI] [PubMed] [Google Scholar]
  9. LEE G. J. Total and peripheral blood flow in acute myocardial infarction. Br Heart J. 1957 Jan;19(1):117–128. doi: 10.1136/hrt.19.1.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. LEVY M. N., FRANKEL A. L. Vasomotor responses to acute coronary occlusion in the dog. Am J Physiol. 1953 Feb;172(2):427–436. doi: 10.1152/ajplegacy.1953.172.2.427. [DOI] [PubMed] [Google Scholar]
  11. Oberg B., Thorén P. Studies on left ventricular receptors, signalling in non-medullated vagal afferents. Acta Physiol Scand. 1972 Jun;85(2):145–163. doi: 10.1111/j.1748-1716.1972.tb05246.x. [DOI] [PubMed] [Google Scholar]
  12. Ramo B. W., Myers N., Wallace A. G., Starmer F., Clark D. O., Whalen R. E. Hemodynamic findings in 123 patients with acute myocardial infarction on admission. Circulation. 1970 Oct;42(4):567–577. doi: 10.1161/01.cir.42.4.567. [DOI] [PubMed] [Google Scholar]
  13. SHARPEY-SCHAFER E. P. Effects of Valsalva's manoeuvre on the normal and failing circulation. Br Med J. 1955 Mar 19;1(4915):693–695. doi: 10.1136/bmj.1.4915.693. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. SHARPEY-SCHAFER E. P., TAYLOR P. J. Absent circulatory reflexes in diabetic neuritis. Lancet. 1960 Mar 12;1(7124):559–562. doi: 10.1016/s0140-6736(60)92773-2. [DOI] [PubMed] [Google Scholar]
  15. SMITH W. W., WIKLER N. S., FOX A. C. Hemodynamic studies of patients with myocardial infarction. Circulation. 1954 Mar;9(3):352–362. doi: 10.1161/01.cir.9.3.352. [DOI] [PubMed] [Google Scholar]
  16. Sleight P., Widdicombe J. G. Action potentials in fibres from receptors in the epicardium and myocardium of the dog's left ventricle. J Physiol. 1965 Nov;181(2):235–258. doi: 10.1113/jphysiol.1965.sp007758. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Thomas M., Malmcrona R., Shillingford J. Circulatory changes associated with systemic hypotension in patients with acute myocardial infarction. Br Heart J. 1966 Jan;28(1):108–117. doi: 10.1136/hrt.28.1.108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Toubes D. B., Brody M. J. Inhibition of reflex vasoconstriction after experimental coronary embolization in the dog. Circ Res. 1970 Feb;26(2):211–224. doi: 10.1161/01.res.26.2.211. [DOI] [PubMed] [Google Scholar]
  19. WEGRIA R., FRANK C. W., MISRAHY G. A., WANG H. H., MILLER R., CASE R. B. Immediate hemodynamic effects of acute coronary artery occlusion. Am J Physiol. 1954 Apr;177(1):123–127. doi: 10.1152/ajplegacy.1954.177.1.123. [DOI] [PubMed] [Google Scholar]

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