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Propranolol may reduce the oxygen requirement of the heart at any level of effort by blocking catecholamine induced increases in the heart rate, systolic blood pressure, and the velocity and extent of myocardial contraction. Propranolol can, in certain patients, be used alone or as an initial agent in patients in whom, in the judgment of the physician, treatment should be started with a beta-blocker rather than a diuretic. Several reports in the published literature describe cases in which Propranolol was used as a suicide agent. Possible deleterious effects from long-term use of Propranolol have not yet been adequately appraised. Treatment must always be initiated and individual titration of dosage carried out using the conventional tablets. Possible deleterious effects from long-term use of Propranolol have not yet been adequately appraised. The elevated outflow pressure gradient which is exacerbated by beta-adrenergic receptor stimulation.