Paradoxic Action of Amyl Nitrite in Coronary Patients

Abstract
Amyl nitrite inhalation in patients with sclerotic coronary vessels is followed by electrocardiographic changes typical of temporary coronary insufficiency. It is suggested that, in such cases, a slight increase of cardiac work (tachycardia) together with a decrease of blood supply (fall in blood pressure), leads to myocardial ischemia. Comparison between an exercise test and amyl nitrite inhalation in the same patients indicates similar results. Amyl nitrite inhalation may be used as a simple functional test in borderline or questionable cases of coronary heart disease.