Oxygen therapy in myocardial infarction: an historical perspective

It is over 100 years since the use of oxygen to relieve angina pectoris was first described by Steele.1 More importantly, it is over 50 years since Russek and colleagues cautioned that the administration of 100% oxygen may actually be contraindicated in patients with myocardial infarction or angina pectoris in whom the arterial oxygen saturation is normal.2 Since this warning, there have been numerous reports of potentially harmful effects of high flow oxygen in the treatment of myocardial infarction, yet it is routine clinical practice to administer oxygen to virtually all patients in this situation. In this essay we have considered, from an historical perspective, the findings from the key studies of the effects of oxygen therapy in patients with myocardial infarction. We propose that randomized controlled trials are urgently required.