One hundred and thirty-one male patients admitted to a coronary care unit with myocardial infarction, later confirmed, were randomly allocated to receive either 10 mg diazepam every six hours, or a matched placebo, for 48 hours. During this period, no differences were found between the treatment groups in the incidence of fatal or non-fatal tachyarrhythmias even when account was taken of differences in the severity of the initial infarct. Monitored blood pressure and heart rate data were comparable as were the patients' self-assessed anxiety levels and symptoms, except that drowsiness was more common in the patients treated with diazepam.

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and the Royal Infirmary, SheffieldThe analgesic pentazocine has been studied in myocardial infarction. A dose of 30 mg given intravenously provokes significant respiratory depression (which may be potentiated by lignocaine). This dose caused a small, but not significant rise in systemic arterial pressure and heart rate when breathing air. Attempts to provoke postural hypotension failed. Changes in pulmonary arterial pressure and arteriovenous oxygen difference were small and not significant.The published reports have been reviewed with a view to determining the most suitable intravenous analgesic for use after myocardial infarction. Pethidine and morphine appear to be unsatisfactory. Pentazocine is preferable to either, but less satisfactory than heroin in a normotensive patient. Dosage should be as small as practicable and injection slow. Oxygen should be given routinely; phenothiazines should not.

Studies have been made of 142 episodes of myocardial infarction to determine whether there is any relation between admission acid-base status and the incidence of ventricular arrhythmias. No The purpose of this study has been to correlate acid-base status found after myocardial infarction with the presence or absence of ventricular arrhythmias over the subsequent 24 hours and to determine the effect of severity of infarction upon any such relation. It should then be possible to determine whether acidbase imbalance has any prognostic guide as to the likelihood of development of these arrhythmias. Patients and methodsStudies were made on I42 episodes of recent (less than 72 hours) myocardial infarction. There were II8 men and 24 women whose ages ranged between 33 and 82 (mean age 57 with a standard