[A case of myocardial infarction associated with pulmonary edema during curettage for hydatidiform mole].
We experienced a case of myocardial infarction associated with pulmonary edema in a patient with hydatidiform mole probably due to methylergometrin and prostaglandin F2 alpha (PGF2 alpha) administered during the operation. A 26-year-old woman was scheduled to have curettage for hydatidiform mole under general anesthesia. She had no previous history of cardiopulmonary disease. During the operation, 0.4 mg of methylergometrin was administered intravenously to induce uterine contraction. Because the contraction was not sufficient, 2 mg of PGF2 alpha was given into the uterine muscle. A few minutes later blood pressure and heart rate increased abruptly and arterial blood gas analysis showed hypoxia and respiratory acidosis. Pulmonary edema was confirmed by chest X-P. After ordinary treatment for pulmonary edema, she was transferred to ICU. Postoperative examinations of ECG, serum enzymes and echocardiography revealed anterior subendocardial infarction. About one month later, methylergometrin test was performed during coronary angiography and this induced coronary vasospasm. PGF2 alpha is also known to cause peripheral as well as pulmonary vasoconstriction. Acute myocardial infarction induced by methylergometrin and PGF2 alpha may be a possible cause of this episode.
Asada
M
M
Department of Anesthesiology, Yokohama City University, School of Medicine.
Nakayama
K
K
Yamaguchi
O
O
Kudoh
I
I
D000328:Adult; D003475:Curettage; D015237:Dinoprost / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000601:surgery*; D008755:Methylergonovine / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000139:chemically induced*; D011247:Pregnancy; D011654:Pulmonary Edema / Q000139:chemically induced*
D015237:Dinoprost; D008755:Methylergonovine