The venlafaxine "heart revenge:" a short report

A 40-year-old white woman with a history of venlafaxine abuse was admitted to our emergency department within 3 days after attempting suicide. On admission, blood pressure was 140/85 mm Hg with 70 beats per minute. The resting 12-lead ECG showed a significant ST-segment elevation in the anterolateral leads consistent with acute anterolateral myocardial infarction (anterolateral AMI). Noninvasive monitoring of blood oxygen saturation showed 97% while she was breathing room air. Laboratory findings showed the increase of troponin I up to 16 microg/L (normal range, 0-0.05 microg/L) and creatine kinase MB subunit levels up to 166 U/L (normal range, 0-25 U/L). An emergency coronary angiogram was normal. Venlafaxine is generally prescribed for the treatment of major depression, as well as, generalized and social anxiety. This is the first time in the literature that we describe an association between myocardial infarction and an overdose with venlafaxine.