[Acute myocardial infarction probably induced by the oral administration of bromocriptine: a case report]

This is a report of a case of acute myocardial infarction which was probably induced by the oral administration of bromocriptine. A 55-year-old man was admitted because of suspected hypothyroidism and dwarfism. The endocrinological examination revealed primary hypothyroidism, and levothyroxine sodium replacement therapy was started. Nine days later, the bromocriptine test was performed for dwarfism. Two hours after the oral administration of 2.5 mg bromocriptine, he had severe chest pain associated with loss of consciousness and hypotension. His electrocardiogram showed marked ST depression and T wave inversion, but no abnormal Q waves. Serial myocardial enzymes and electrocardiograms confirmed acute non-transmural myocardial infarction. During coronary angiography performed about three months later, coronary arterial spasm was induced by the intravenous administration of ergonovine maleate. This experience suggests that bromocriptine, a derivative of ergot alkaloids, can cause coronary arterial spasm, and subsequent myocardial infarction. To our knowledge, bromocriptine-induced myocardial infarction has not been previously reported in Japan.