Syncope in a 65-year-old woman after nitrate ingestion.
A 65-year-old woman with angina pectoris presented with syncope after sublingual ingestion of isosorbide dinitrate (5 mg). Her response to a postural challenge test, without medication, was normal. In a postural challenge test after administration of isosorbide dinitrate (5 mg), blood pressure decreased from 120/67 to 65/35 mmHg, followed by syncope with a sudden decrease in pulse rate from 85 to 60 beats/min. No evidence of myocardial infarction was detected. Elderly patients for whom nitrate has been prescribed should be warned of the occurrence of hypotension, leading to unconsciousness.
Chong
Y
Y
Department of General Medicine, Kyushu University Hospital, Fukuoka.
Yamamoto
T
T
Hayashi
J
J
Tsuchihashi
T
T
Kashiwagi
S
S
D000286:Administration, Sublingual; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000139:chemically induced*; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000009:adverse effects*; D016683:Supine Position; D013575:Syncope / Q000139:chemically induced*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*
D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate