A 45-year-old woman with almost normal coronary arteries suffered from acute inferior myocardial infarction after taking 2 tablets (2.0 mg) of ergotamine tartrate for headache. She had had attacks of variant angina and spasm of the right coronary artery had been demonstrated during the attack. After the recovery from myocardial infarction the intravenous injection of ergonovine maleate 0.05 mg induced spasm of the right coronary artery again. We conclude that acute myocardial infarction in this patient was probably caused by coronary arterial spasm induced by ergotamine tartrate.
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References
1.
Meller, J., Pichard A., Dack, S.: Coronary arterial spasm in Prinzmetal's angina: A proved hypothesis. Am. J. Cardiol., 37: 938, 1976.
2.
Hillis, L.D. , Braunwald, E.: Coronary artery spasm. N. Engl. J. Med., 299: 695, 1978.
3.
Heupler, F.A. , Proudfit, W.L., Razani, M., et al.: Ergonovine maleate provocative test for coronary arterial spasm. Am. J. Cardiol., 41: 931, 1978.
4.
Brazeau, P.: Oxytocin, prostaglandins and ergot alkaloids, in The Pharmacological Basis of Therapeutics. New York, Macmillan, 1975, p. 872.
5.
Stein, I.: Observation on the action of ergonovine on the coronary circulation and its use in the diagnosis of coronary artery insufficiency. Am. Heart J., 37: 36, 1949.
6.
Benedict, C.R. , Robertson, D.: Angina pectoris and sudden death in the absence of atherosclerosis following ergotamine therapy for migraine. Am. J. Med., 67: 177, 1979.
7.
Yasue, H., Omote, S., Takizawa, A., et al.: Exertional angina pectoris caused by coronary arterial spasm: Effects of various drugs. Am. J. Cardiol., 43: 647, 1979.
8.
Oliva, P.B., Breckinridge, J.C.: Arteriographic evidence of coronary arterial spasm in acute myocardial infarction . Circulation, 56: 366, 1977.
9.
Maseri, A., L'Abbate, A., Baroldi, G., et al.: Coronary vasospasm as a possible cause of myocardial infarction. A conclusion derived from the study of "preinfarction" angina. N. Engl. J. Med., 299: 1271, 1978.
