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Contrast media during coronary arteriography: electrocardiographic changes in the presence of normal coronary arteries

Cardiac Department, King's College Hospital, London SE5 9RS

In forty patients with normal coronary arteries, the electrocardiographic changes secondary to Urografin 76 and Hypaque 85 injection into both coronary arteries were monitored. Hypaque caused significantly greater prolongation of the PR interval (p < 0.001), depression of the ST segment (p < 0.05) and depth of T wave inversion (p < 0.05). These effects were more noticeable during right coronary artery injection. Both contrast media slowed the heart rate equally during right and left coronary artery injection.

In the absence of coronary arterial disease the ECG changes secondary to contrast media injection probably reflect a direct toxic effect. It is possible that premedication with atropine will reduce these effects. Urografin 76 appears the less toxic of the two media, although one case of ventricular fibrillation occurred with each.

Received for publication February 1, 1978.