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Zolmitriptan induced acute coronary syndrome: a unique case
Marcus Smith1, Harsh Golwala, Pedro Lozano
1Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. marcus-smith@ouhsc.edu
American Journal of Therapeutics
|August 27, 2011
Summary
This case report details a myocardial infarction in a patient taking zolmitriptan, a common migraine medication. Coronary angiography revealed vasospasm, successfully treated with nitroglycerin, highlighting a rare adverse effect of triptans.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Triptans are widely prescribed for acute migraine treatment.
- Coronary vasospasm is a known potential side effect of triptans.
- Myocardial infarction associated with triptan use in patients with normal coronary arteries is rare.
Observation:
- A 58-year-old male presented with chest pain.
- Electrocardiogram showed ST segment depression.
- Coronary angiography revealed diffuse spasm of the distal right coronary artery.
Findings:
- The patient experienced a myocardial infarction after taking oral zolmitriptan.
- Intracoronary nitroglycerin rapidly reversed the observed coronary vasospasm.
- This is the first reported case with clear angiographic evidence of vasospasm reversal.
Implications:
- This case underscores the importance of considering coronary vasospasm in patients with chest pain taking triptans.
- It highlights a rare but serious adverse effect of zolmitriptan.
- Further research may be warranted to elucidate the precise mechanisms and incidence of triptan-induced myocardial infarction.
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