l-Norepinephrine Myocarditis

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Abstract
The pathogenic activity of 1-norepinephrine (l-NE) in clinical and experimental material is presented. The prominent autopsy findings in patients following treatment with l-NE and frequently in patients with pheochro-mocytoma are focal myocarditis and hemorrhagic lesions of the pericardium and endocardium. In children the prominent lesion is necrotizing endarteritis of the small bowel. An experiment devised to parallel the clinical use of 1-NE, using intact dogs and continuous intravenous infusion in therapeutic doses, revealed multiple morphologic changes at autopsy. Focal myocarditis was uniformly present in association with subendo-cardial and subpericardial hemorrhages. Another constant finding was necrotizing arteritis of the gastrointestinal tract. The severity of the cardiac lesions warrants a reappraisal of the current trend in using 1-NE for prolonged periods of time and in high dosage.