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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
Summary
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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