Prolonged Use of Arterenol for Shock Following Myocardial Infarction With Patient Survival

SURVEY the literature, to the best of my knowledge, has not revealed any case of shock following myocardial infarction treated with continuous levarterenol (Levophed) drip for over eight days with patient survival.* It is estimated that the mortality rate is between 80% and 90%⁷in sustained hypotension following myocardial infarction. The delayed gradual onset of shock has been described⁸as the clinical manifestation of progressive failure of the infarcted left ventricle and as almost invariably fatal. This is in contradistinction to the hypotension that may follow immediately after the onset of the infarct, in which case about 50% of the patients recover spontaneously within one hour. A 52-year-old well-nourished white women developed recurrent episodes of substernal pain of 24 hours' duration. Her husband had died of a brain tumor the preceding day. When first seen at home, she was lying in bed having recurrent attacks of anginal pain