Acute Myocardial Infarction Following Oral Methyl-Ergometrine Intake
- 116 Downloads
Ergot derivatives are frequently administrated during cesarian delivery, induced abortion, or post-partum hemorrhage to promote uterine contractions. Ergot derivatives may also induce coronary spasm and intravenous ergonovine is used in cardiac catheterization laboratories as a diagnostic agent. Serious ischemic cardiac events related to ergonovine are rare and have most often been described after intravenous use. We report the case of a 38-year-old woman with a ST elevation myocardial infarction (STEMI) few days after artificially induced abortion by oral prescription of methylergometrine. Coronary angiography performed 2 days after onset of chest pain did not reveal any abnormalities of the coronary arteries but a provocative test using intravenous methylergometrine was positive with reproduction of chest pain, ECG changes and with a significant narrowing localized on the second segment of the left anterior descending artery at the angiogram. Thus, since methylergometrin may clearly induce coronary spasm when prescribed orally, chest pain occurring under oral treatment should require immediate attention even if atypical or in the absence of cardiovascular risk factors.
KeywordsAcute myocardial infarction Methylergometrine Coronary spasm
- 1.de Groot, A. N., van Dongen, P. W., Vree, T. B., Hekster, Y. A., & van Roosmalen, J. (1998). Ergot alkaloids: Current status and review of clinical pharmacology and therapeutic use compared with other oxytocics in obstetrics and gynaecology. Drugs, 56, 523–535. doi: 10.2165/00003495-199856040-00002.PubMedCrossRefGoogle Scholar
- 2.Lange, R. A., & Hillis, L. D. (1994). Assessment of cardiovascular function. In C. J. Pepine, J. A. Hill, & C. R. Lambert (Eds.), Diagnostic and therapeutic cardiac catheterization (2nd ed., pp. 394–429). Baltimore: Williams & Wilkins.Google Scholar
- 8.Yaegashi, N., Miura, M., & Okamura, (1999). Acute myocardial infarction associated with postpartum ergot alkaloid administration. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 64, 67–68. doi: 10.1016/S0020-7292(98)00212-4.Google Scholar