[Acute anterior wall infarct in a 31-year-old patient after administration of methylergometrin for peripartal vaginal hemorrhage].
METHODS
After administration methylergometrine 30 minutes after delivery for peripartal vaginal bleeding a 31-year-old female patient developed an acute anterior wall myocardial infarction. Coronary angiography 7 hours after beginning of the chest pain demonstrated a dissection with a large thrombus in the proximal left anterior descending artery, followed by a complete occlusion in the periphery of the vessel (Figure 1). After applying rtPA intravenously, coronary angiography showed 24 hours later an open vessel without thrombotic material (Figure 2).


CONCLUSIONS
Coronary artery spasm induced by methylergometrine must be regarded as the main reason for the dissection and thrombus formation followed by a myocardial infarction.
Ribbing
M
M
Klinik und Poliklinik für Innere Medizin C-Kardiologie und Angiologie, Institut für Arterioskleroseforschung, Universitätsklinikum Münster. ribbing@uni-muenster.de
Reinecke
H
H
Breithardt
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G
Kerber
S
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D000328:Adult; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000139:chemically induced / Q000175:diagnosis; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008755:Methylergonovine / Q000008:administration & dosage / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis; D006473:Postpartum Hemorrhage / Q000188:drug therapy*; D012307:Risk Factors
D008755:Methylergonovine
Akuter Vorderwandinfarkt einer 31-jährigen Patientin nach Gabe von Methylergometrin aufgrund peripartaler vaginaler Blutung.