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Serial plasma adrenaline and noradrenaline levels in myocardial infarction using a new double isotope technique.

The plasma levels of adrenaline and noradrenaline have been measured in IO patients with myocardial infarction using a new double isotope dilution technique. Adrenaline and noradrenaline levels were measured on admission and at 12-hourly intervals for the next 5 days. There were significant correlations between raised noradrenaline and (i) raised systolic blood pressure, (2) the presence of pulmonary oedema, and (3) transfer of patients back to the general wards; and between raised adrenaline levels and (i) the presence ofpulmonary oedema, and (2) the presence of ventricular ectopics. The results suggest that emotional factors play a part in the increase in catecholamine levels in these patients and that adequate sedation may result in lower levels. One patient with cardiac arrest followed by complete heart block and cardiogenic shock had particularly high catecholamine levels, exceeding those observed in a case ofphaeochromocytoma.