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Hypoglycaemia-induced myocardial infarction as a result of sulphonylurea misuse

B T Corley1, C Davenport, L Delaney

  • 1Department of Endocrinology, Beaumont Hospital, Dublin, Ireland. diarmuidsmith@beaumont.ie

Diabetic Medicine : a Journal of the British Diabetic Association
|January 6, 2011
PubMed
Abstract

Insights

Hypoglycaemia from glibenclamide, a sulfonylurea, can trigger myocardial infarction (MI) even in non-diabetic individuals. Prompt treatment of low blood sugar resolved the cardiac event in this case.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Intensive glucose control in Type 2 diabetes is linked to increased cardiovascular events, often associated with hypoglycemia.
  • However, direct causality between hypoglycemia and myocardial infarction (MI) is infrequently documented.

Observation:

  • A 76-year-old non-diabetic woman presented with MI symptoms, left bundle branch block, and elevated troponin.
  • She was found to be hypoglycemic (plasma glucose 2.5 mmol/l) and had mistakenly taken glibenclamide, a sulfonylurea, for weeks.
  • Cardiac symptoms resolved upon hypoglycemia treatment; coronary angiography revealed no significant disease.

Findings:

  • This case demonstrates sulfonylurea-induced MI in a patient without diabetes.
  • Acute hypoglycemia was directly implicated in precipitating the myocardial infarction.

Implications:

  • Highlights the potential cardiovascular risks of sulfonylurea drugs, particularly in cases of accidental ingestion or overdose.
  • Underscores the critical need to consider hypoglycemia as a cause of MI, even in patients without a diabetes diagnosis.
  • Emphasizes the adverse impact of acute hypoglycemia on the cardiovascular system.

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