Nitric oxide (NO) production by the human heart has been demonstrated in patients undergoing cardiac surgery. Similar to what has been described in other species, a basal production of NO by the human heart is seen (126 +/- 42 pmol/min per gram). Following reperfusion, at the end of the procedure, the level of NO production increases significantly reaching concentrations of 1430 +/- 330 pmol/min per gram. Increased activity for the enzyme NO synthase (NOS) (8.0 +/- 1.2 pmol/mg prebypass vs 26.4 +/- 4.8 pmol/mg postbypass) coincides with changes in NO production and occurs at a time when myocardial stunning is clinically detectable. The significance of these findings is discussed and suggest a role for NO in the pathophysiology of myocardial stunning.