A patient with four artificial heart valves after ergotamine therapy.

A 67-year-old female was evaluated in the out-patient clinic because of shortness of breath on exertion and regular spells of fever. She had been taking ergotamine tartrate to treat migraine for more than 30 years. The patient had undergone aortic-valve replacement for aortic insufficiency three years before.

Can a single vasodilator be responsible for both coronary autoregulation and metabolic vasodilation?

To test the hypothesis that both coronary autoregulation and metabolic vasodilation can be mediated by the same substance, we have analysed measured autoregulation curves with the aid of a simple mass balance model. In an open-chest dog preparation, increasing the heart rate by pacing results in a nearly parallel shift of the autoregulation curve to a higher flow (Q) level. We assume a unique relationship between vascular conductance and interstitial concentration of a vasodilating substance [A].