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Methylergometrine-induced coronary artery spasm causing total occlusion of all three coronary arteries

N Danchin1, C Selton-Suty, Y Juilliere

  • 1Service de Cardiologie B, CHU Nancy-Brabois, Vandoeuvre, France.

European Heart Journal
|December 1, 1990
PubMed

Insights

Methylergometrine triggered severe coronary artery spasm in a patient with mitral valve disease, leading to dangerous artery occlusion. Prompt intracoronary nitrate and nifedipine administration was required for treatment.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Rheumatic mitral valve disease can predispose individuals to atypical cardiac events.
  • Nocturnal chest pain can indicate underlying coronary artery issues.

Observation:

  • A 58-year-old male presented with recent onset nocturnal chest pain.
  • Coronary angiography revealed normal coronary arteries.
  • Intravenous methylergometrine administration induced total occlusion of all three coronary arteries.

Findings:

  • Methylergometrine precipitated severe coronary artery spasm.
  • Electromechanical dissociation occurred secondary to the spasm.
  • Intravenous isosorbide dinitrate was ineffective in relieving the spasm.

Implications:

  • This case highlights a rare but severe adverse reaction to methylergometrine.
  • Coronary artery spasm can occur in patients with valvular heart disease.
  • Intracoronary nitrates and nifedipine are effective in managing refractory coronary spasm.

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