A. Rudolph, M. Paul, L. Sommer
Mar 1, 1958
Citations
0
Influential Citations
68
Citations
Journal
American Heart Journal
Abstract
Abstract The acute effects of intravenous administration of tolazoline hydrochloride on the cardiovascular dynamics have been studied in 10 patients with pulmonary arterial hypertension, all but 1 associated with congenital heart disease. Five patients had ventricular septal defects, 2 patent ductus arteriosus, 2 atrial septal defect, and 1 had no demonstrable cardiac lesion. Pulmonary and systemic pressures and pulmonary blood flow were measured in all patients; and in 3 cases with left-to-right shunt simultaneous systemic blood flow measurement was obtained by insertion of a second cardiac catheter into the right atrium. Systemic vascular effects of tolazoline were manifested by flushing of the skin, rise in measured skin temperature, increase in digital blood flow, and decrease in calculated systemic vascular resistance. Pulmonary vascular resistance was not significantly affected in 9 patients. In 1 patient there was a moderate reduction of pulmonary resistance, with an increase in left-to-right shunt through a ventricular septal defect. The effectiveness of tolazoline in reducing pulmonary vascular resistance as observed by other investigators could not be corroborated in our patients. The possibility is considered that the elevated pulmonary vascular resistance associated with congenital heart disease is due to organic changes, whereas in other diseases vascular spasm may have a significant role.