Advanced

Non-ST Elevation Myocardial Infarction Induced by Sildenafil Consumption in a Patient with No Coronary Artery Disease History: A Case Report

Author : I.M.E.A. Wardhana, P.G. Budiana*
Upload Date : 19-04-2018

Background: Sildenafil citrate, which works effectively in the treatment of male erectile dysfunction, in some literatures revealed a number of serious cardiovascular events, including myocardial infarction (MI).

Objective: To present a case with Non ST Elevation Myocardial Infarction induced by sildenafil consumption with no coronary artery disease (CAD) history.

Case Illustration: A 52-years-old male patient presented to RSUD Badung Mangusada emergency department with chest pain for 1 hour after taking herbal medicine that contain Viagra (sildenafil citrate) before any attempted sexual activity. He has uncontrolled hypertension and smoking 4 boxes a day. No history of other systemic disease. The patient's vital sign is normal. Initial electrocardiogram showed T inversion over lead III and aVF and there was an increase level of CKMB (71,2 ng/mL) and hs Troponin I (7544,5 ng/L). The patient was diagnosed with NSTEMI. The patient underwent a coronary angiography and it showed stenosis (90%) at proximal until mid RCA, subtotal stenosis after RV branch, and total stenosis before PDA; stenosis after D1 unti D2 branch of LAD (60%); stenosis after OM1 (80%) and subtotal stenosis after OM3 of LCx.

Discussion:  There is a growing body of evidence demonstrating that sildenafil use is not associated with an increased risk for cardiovascular events but patients with known CAD using nitrates are more at risk of developing MI after receiving sildenafil from so called coronary steal phenomenon. Recent studies indicate that erectile dysfunction is a harbinger of CAD, as atherosclerosis affects both coronary and penile vasculature. On the contrary, sildenafil-associated MI is rarely seen in patients without previous history of coronary artery disease (CAD) as happen to our patient. Li et al showed that sildenafil, a cGMP-enhancing agent, promoted von Willebrand Factor or thrombin-induced platelet aggregation.

Conclusion: This report shows a rare sildenafil-associated myocardial infarction in a patient without previous history of CAD. Further studies and data are needed to prove the association between sildenafil intake and acute coronary syndrome.

KEYWORDS : NSTEMI, Myocardial Infarction, Sildenafil


Save Item
Download
Similar Articles

The Predictors of No Reflow Phenomenon after Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction: A Meta-Analysis(Mohammad Saifur Rohman)

Q/R duration as a Predictor of No-Reflow in Patients with Acute Anterior Myocardial Infarction Who Underwent Primary Percutaneous Intervention(P. Meidianaser, Andri, F. Harben, S. Masrul)

Association between Left Ventricular Global Longitudinal Strain and Functional Capacity Measured with 6 MWT in Patients after Acute Myocardial Infarction(P. Wulandari, T. Wasyanto, N. Purwaningtyas)

Comparison of Interleukin-6 Post Percutaneous Coronary Intervention between Patients with Acute Myocardial Infarction that Underwent Complete and Incomplete Revascularization(P. K. Dewi, S. Rifqi, N. Anggriyani, N. Wijayahadi)

Association between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarctions Patients(A. A. Nursidiq, N. Purwaningtyas, T. Wasyanto)

White Blood Cell Count to Mean Platelet Volume Ratio as a Novel Non-Invasive Marker Predicting Short-term Outcomes in Patients with Non-ST Elevation Myocardial Infarction(Y. Saragih, B. Napitupulu, A.N. Nasution, A.H. Raynaldo, H. Hasan)

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction(J. Suganti, A. C. Lubis, A. A. Siregar, A. Sitepu, C. A. Andra, A. N. Nasution, H. Hasan)

Assessment of Coronary No-reflow in Patients with Acute Anterior STEMI Underwent Primary Percutaneous Coronary Intervention Using P Wave Peak Time Parameter(P. Andri, M. Meidianaser, Syaoqi, S. Masrul)

Cardiac Power Output Predicts In-Hospital Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction(Y. F. Siregar, K. K. Ilyas, A. A. Siregar, H. Hasan)

Selvester Score in Myocardial Infarction, Could It Predict Degree of Severity in Coronary Lesion?(H. Pribadi, J. A. Pangemanan, S. H. Rampengan, A. L. Panda, I. Adriana, Ronaldi, V. F. K. Candra, N)

Estimated Glomerular Filtration Rate And Length of Stay in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention(H. Haryadi, A. A. Asrial, L. Raharjoyo, N. Virginia, K. Rizky ,Y. Herry)

Reduced Left Ventricular Ejection Fraction as A Predictor In-Hospital Major Cardiovascular Event in Patients Admitted with Acute Myocardial Infarction at Sanglah General Hospital Bali(I. D. G. D. Sumajaya, L. O. S. Suastika, A. A. A. D. A. Yasmin, I. G. N. P. Gunadhi)

Clinical Profile of patients with Acute Coronary Syndrome in Public Hospital in Bekasi, West Java, Indonesia(B.A.Pratama, J.S. Purnama, K. Priyantoro)

The Role of Sildenafil towards Health Related Quality of Life in Adults with Pulmonary Arterial Hypertension Related Uncorrected Secundum Atrial Septal Defect(F. Hidayati*, P.P.R. Gharini*, A.B. Hartopo*, D.W. Anggrahini*, L.K. Dinarti* )

Electrocardiographic Change Mimicking ST Elevation Myocardial infarction in Subdural Hemorrhage: Diagnostic Dilemma(P.I.N. Sigit, Y. Ahmad)

Isolated Posterior Myocardial Infarct: The Deadly Nightshade of the Electrocardiography(B.D.Guntoro, D.Ilmasari, M.G.Soewandi)

Localized ST Elevation in ECG: Acute Myopericarditis Mimicking ST Elevation Myocardial Infarction(T. N. P. Adityaputra, L. O. S. Suastika)

Recurrent Acute Myocardial Infarction in A-63 years old Man with Hypersensitivity to Aspirin Therapy: How to Deal with it?(M. Sanjiwani, N. Wiryawan)

Double Culprit Coronary Arteries in ST Elevation Myocardial Infarction Treated with Primary Percutaneous Intervention: A Case Report(H.H. Satoto, R. Puspitoadhi, R.A. Raharjo, S. Sungkar, I. Uddin)

Peri-Infarction Pericarditis, Rare Complication of Myocardial Infarction(S.A. Hutomo, Andrianto)

New ST-Segment Elevation After Coronary Artery Bypass: A Case Report(N. O. H. Rantung, L. A. Natalino, V. Sariowan, A. E. Haurissa, A. Tangkilisan, H. Abraham, J.A. Pang)

Extensive Anterior ST elevation Myocardial Infarction in Reproductive Woman Using Oral Contraceptive Pills (D.Ilmasari, A.F.Khalid, M.G.Soewandi)

Converting Persistent Non-Valvular Atrial Fibrillation to Sinus Rhythm in Critical Stenosis of Left Circumflex (LCX) Artery: Is it Ischaemic-related?: A Case Report(F. Ratih, M.F. Rizky, K. Agoes)

Post infarction ventricle septal rupture: it is not always a lethal condition.(N.E. Damaiati, R. A. Sukaton, H. Isnanijah)

Subacute Coronary Stent Thrombosis in Patient after Elective Percutaneous Coronary Intervention : Causes, Risk Factors and Management(A. Chairunnisa, A. Wardhani, Y. Herry, I. Uddin, Safir)

Acute Pulmonary Embolism Mimicking an Acute Myocardial Infarction : A Case Report(O. M. Siregar, Y. Sarastri, Z. Safri, H. Hasan, )

How To Manage Total Atrioventricular Block In Inferior-Posterior AMI; Is PCI More Superior Than Permanent Pacemaker?(N.D Nuarisa, Y.H Oktaviono)

Copyrights 2018 ASMIHA | Managed by Indonesia Medical Event (IME)