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HERO ID
2988984
Reference Type
Journal Article
Title
Acute myocardial infarction after sildenafil citrate ingestion
Author(s)
Kekilli, M; Beyazit, Y; Purnak, T; Dogan, S; Atalar, E
Year
2005
Is Peer Reviewed?
Yes
Journal
Annals of Pharmacotherapy
ISSN:
1060-0280
EISSN:
1542-6270
Volume
39
Issue
7-8
Page Numbers
1362-1364
Language
English
PMID
15914518
DOI
10.1345/aph.1E665
Web of Science Id
WOS:000230229400034
Abstract
OBJECTIVE:
To report a case of acute myocardial infarction (MI) associated with the use of oral sildenafil in a nitrate-free patient.
CASE SUMMARY:
A 45-year-old man was admitted to the hospital with acute left-sided chest pain, nausea, and vomiting that started approximately 30 minutes after taking sildenafil 100 mg before a sexual contact. The patient was diagnosed with an acute anterior MI, and therapy with aspirin, metoprolol, and unfractionated heparin was initiated. Early coronary reperfusion treatment with primary percutaneous transluminal coronary angioplasty was performed after initial evaluation. Balloon angioplasty followed by coronary stenting was performed successfully in the 80%-occluded left anterior descending artery. The patient was discharged one week after the coronary intervention without complication.
DISCUSSION:
Sildenafil-associated MI is rarely seen in patients without documented coronary artery disease. By inhibiting phosphodiesterase type 5, sildenafil can cause an increase in cyclic guanosine monophosphate levels, which mediates the relaxation of vascular smooth muscle in the corpus cavernosum. Although sildenafil can cause a major decline in systemic arterial pressure in the existence of organic nitrates, physicians should be aware of its adverse cardiovascular effects even in nitrate-free patients. The Naranjo probability scale indicates that sildenafil was the possible cause of the MI.
CONCLUSIONS:
Sildenafil may rarely be associated with MI in patients with no known cardiac history. Physicians should be aware of this rare and serious adverse reaction to sildenafil and counsel patients not to take sildenafil before undergoing a complete physical evaluation and further testing if warranted.
Tags
IRIS
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Nitrate/Nitrite
Supplemental LitSearch Update 1600-2015
PubMed
WoS
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