Neuroleptic malignant syndrome and acute myocardial infarction: case report and review

The neuroleptic malignant syndrome (NMS) is a potentially life threatening reaction usually observed following administration of dopaminergic antagonists (neuroleptic medications, e.g., phenothiazines, thioxanthenes, and haloperidol). NMS is characterized by mental status changes, muscle rigidity (and movement disorders such as dyskinesias and akathisias), leukocytosis, hyperthermia, and autonomic dysfunction. Because of the variants of this disease, the physician must remain alert to its possibility when confronted with emergency care of patients having received neuroleptics, particularly when hypermetabolic states are etiologically consequential in the development of other disease processes, for example, acute myocardial infarction.