New Arterial Hypertension During Myocardial Infarction

Degenerative lesions of a coronary chemoreceptor and nearby neural elements in the hearts of victims of sudden death

“…Clinical evidence of such events observed in humans during either angina pectoris or acute myocardial infarction (especially the early phase) have long been familiar to experienced clinicians (13,14) and were given the colorful description of "autonomic storms" by Sir Thomas Lewis (15). Although it was once suggested (16) that the origin of these autonomic storms must be from some then undefined intracardiac chemoreceptor, we (17) and others (18) have subsequently presented evidence to indicate that the origin in man is within the coronary chemoreceptor which is the special subject of the present study.…”

“…Additionally, some of the autonomic neural efferent signals to the heart from extracardiac receptors or from the brain may also traverse this same region, further compounding any possible functional significance of lesions found there. And, in ischemic heart disease where this cardi-ogenic hypertensive chemoreflex has a putative role (16)(17)(18), the serotonin activating the reflex is probably released by locally aggregating platelets in the main left coronary artery, a formidably dangerous site for any thrombotic process.…”

Homage to James B. Herrick: A Contemporary Look at Myocardial Infarction and at Sickle-Cell Heart Disease

“…75,76 Evidence has previously been presented 77 that severe bouts of new hypertension associated with either angina pectoris or early acute myocardial infarction 78 may be mediated by the release of serotonin from platelets clumped within this chemoreceptor of the heart. 76,79 The arrhythmogenic effect of such acute hypertension, which is sometimes double the level of resting blood pressure, could cause lethal electrical instability in the heart, whether in the usual forms of myocardial infarction or as in TTP or sickle-cell heart disease.…”