A Novel Case of Spontaneous Coronary Artery Dissection During Cabergoline Therapy for Prolactinoma

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Prolactinoma is a common pituitary tumor often treated with dopamine agonists like cabergoline.
• Spontaneous Coronary Artery Dissection (SCAD) is a rare but serious condition causing chest pain and myocardial infarction.
• The association between cabergoline and SCAD is not well-established.

Observation:

• A 31-year-old woman with hypertension and prolactinoma, treated with cabergoline, presented with acute chest pain.
• Diagnostic workup revealed non-ST-segment elevation myocardial infarction.
• Coronary angiography demonstrated double-vessel spontaneous coronary artery dissection.

Findings:

• The patient was successfully treated with coronary artery bypass grafting.
• This case highlights a potential, albeit rare, adverse cardiovascular event associated with cabergoline therapy.
• Further research is needed to elucidate the potential link between cabergoline and SCAD.

Implications:

• Clinicians should maintain a high index of suspicion for SCAD in patients on cabergoline presenting with chest pain.
• This case underscores the importance of considering drug-induced cardiovascular complications.
• Understanding this association may inform future treatment guidelines for prolactinoma.