Treatment of Acute Left-Sided Heart Failure with Intramuscular Injection of Chlorpromazine

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概要

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• Hemodynamic responses to intramuscular injection of 5 to 10mg (average 8.5mg) of chlorpromazine were assessed in 10 patients with acute left-sided heart failure (treated group). Left ventricular filling pressure, blood pressure, heart rate, and cardiac index were measured before the injection and for 6 hours thereafter. In 8 patients with heart failure, the same hemodynamic monitoring was performed without the injection of chlorpromazine (control group).In treated group significant reduction of left ventricular filling pressure was observed at 5min after the injection of chlorpromazine. Left ventricular filling pressure showed a peak reduction from an average of 27.2 to 18.8mmHg (-30.8%, p<0.001) at 15min, and a significant reduction persisted for 6 hours. At 15min, mean blood pressure was reduced slightly (101 to 92mmHg, -9.0%, p<0.05) and cardiac index tended to increase slightly (2.11 to 2.28L/min/M2, +7.8%, NS). Heart rate was unchanged. Relief of symptoms of pulmonary congestion was also observed within 15min. Improvement of symptoms of pulmonary congestion was more prominent particularly in 3 patients who had severe dyspnea and stridor. In control group, left ventricular filling pressure, blood pressure, and heart rate showed no significant change over 6 hours.The present study suggested that intramuscular injection of chlorpromazine at the dosage of 5 to 10mg showed rapid and marked clinical improvement without significant side effects and therefore its use may be indicated in patients with acute left-sided heart failure, especially in paroxysmal episodes.

• International Heart Journal刊行会の論文

著者

• Iwasaki Tsutomu

  Department Of Internal Medicine Tokyo Metropolitan Geriatric Hospital

• MIFUNE Junichiro

  Fukui Cardiovascular Center

• Mifune Jun-ichiro

  Fukui Cardiovascular Center

• MATSUSHITA Satoru

  Department of Internal Medicine,Tokyo Metropolitan Geriatric Hospital

• MURAKAMI Mototaka

  Department of Internal Medicine,Tokyo Metropolitan Geriatric Hospital

• SHINAGAWA TATSUO

  Department of Medicine, Tokyo Metropolitan Geriatric Hospital and Department of Clinical Physiology,

• Mifune Junichiro

  Department Of Internal Medicine Fukui Cardiovascular Center

• Mifune Jun-ichiro

  Department Of Internal Medicine Fukui Cardiovascular Center

• Kuwajima Iwao

  Department Of Cardilogy Tokyo Metropolitan Geriatric Hospital

• Sakai Makoto

  Department Of Biology School Of Education Waseda University

• Mifune Junichiro

  Department Of Medicine Tokyo Metropolitan Geriatric Hospital And Department Of Clinical Physiology T

• Kuramoto Kizuku

  Department Of Cardiololgy Tokyo Metropolitan Tama Geriatric Hospital

• Ueda Keiji

  Department Of Microbiology Osaka University Graduate School Of Medicine

• Inoue Hiroshi

  Department Of Electrical And Electronic Engineering Akita University

• Ueda Keiji

  Department Of Internal Medicine Faculty Of Medicine University Of Tokyo

• Inoue Hiroshi

  Departmcnt Of Biology Faculty Of Science Kyushu University:(present)department Of Biology Kyushu Den

• Matsushita Satoru

  Department Of Cardiololgy Tokyo Metropolitan Tama Geriatric Hospital

• Ueda Keiji

  Department Of Cardiology Tokyo Metropolitan Geriatric Hospital

• IWASAKI TSUTOMU

  Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital

• MIFUNE Junichiro

  Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital

• KUWAJIMA Iwao

  Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital

• SHINAGAWA Tatsuo

  Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital

• INOUE Hiroshi

  Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital

• MURAKAMI Mototaka

  Department of Internal Medicine (II), School of Medicine, University of Kanazawa

• KURAMOTO Kizuku

  Department of Cardiology, Tokyo Metropolitan Geriatric Hospital

• MATSUSHITA Satoru

  Department of Cardiology, Tokyo Metropolitan Geriatric Hospital

• Inoue Hiroshi

  Deparment of Neurosurgery, Gunma University School of Medicine and Gamma Unit Center, Hidaka Hospital

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