Cardiovascular Uses

Atropine can be useful in patients with carotid sinus syncope. This condition results from excessive activity of afferent neurons whose stretch receptors are in the carotid sinus. By reflex mechanisms, this excessive afferent input to the medulla oblongata causes pronounced bradycardia, which is reversible by atropine.

Atropine can be used in the differential diagnosis of S-A node dysfunction. If sinus bradycardia is due to ex-tracardiac causes, atropine can generally elicit a tachy-cardic response, whereas it cannot elicit tachycardia if the bradycardia results from intrinsic causes. Under certain conditions, atropine may be useful in the treatment of acute myocardial infarction. Bradycardia frequently occurs after acute myocardial infarction, especially in the first few hours, and this probably results from excessive vagal tone. The increased tone and bradycardia facilitate the development of ventricular ectopy. Although atropine sulfate has proved beneficial in patients whose bradycardia is accompanied by hypotension or ventricular ectopy, it is generally not otherwise recommended in this condition. Use of atropine is not without hazard, because cardiac work can be increased without improved perfusion, and ventricular arrhythmias may occur. Atropine can also be used to induce positive chronotropy during cardiopulmonary resuscitation.

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