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Sildenafil citrate and Torsade de pointes
Jorge L Falcón-Chévere1, José G Cabañas, Idaliz Canales-Colón
1University of Puerto Rico School of Medicine, Emergency Medicine Department.
Boletin De La Asociacion Medica De Puerto Rico
|September 2, 2008
Summary
Sildenafil citrate, used for erectile dysfunction, may cause dangerous cardiac events. This case highlights a potential link between Sildenafil use, myocardial infarction, and life-threatening Torsade de Pointes.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Sildenafil citrate is a phosphodiesterase-5 inhibitor used for erectile dysfunction.
- While known for vasodilation, particularly with nitrates, it has less recognized cardiac risks at higher doses.
Observation:
- A 49-year-old man presented with epigastric pain after taking 50 mg of Sildenafil citrate.
- The patient was diagnosed with an acute ST-elevation inferior myocardial infarction (STEMI).
Findings:
- Shortly after STEMI diagnosis, the patient developed polymorphic ventricular tachycardia (Torsade de Pointes).
- This occurred prior to thrombolytic therapy, suggesting a potential drug-induced effect.
Implications:
- This case suggests a possible association between Sildenafil citrate, acute myocardial infarction, and the development of Torsade de Pointes.
- Heightened awareness of this potentially lethal side effect is crucial, especially in patients with coronary artery disease.
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