Acute myocardial infarction during continuous electrocardiographic ST segment recording. Possible role of bradycardia and hypotension induced by glyceryl trinitrate.

A 62 year old man developed an inferior wall myocardial infarction during ambulatory ST segment monitoring. Before the onset of persistent ST segment elevation he had taken several glyceryl trinitrate tablets, which was followed by bradycardia and symptoms of hypotension. Whether a paradoxical reaction to glyceryl trinitrate may have triggered the development of myocardial infarction in this case is uncertain.