Acute myocardial infarction after over-the-counter use of pseudoephedrine.
Pseudoephedrine is a commonly used over-the-counter decongestant with sympathomimetic activity. We present the case of a previously healthy young man who had an acute myocardial infarction 45 minutes after ingesting the recommended dose of an over-the-counter cold remedy containing pseudoephedrine. Elevations of cardiac-specific creatinine kinase and cardiac troponin I confirmed the diagnosis. Cardiac catheterization 8 hours later revealed normal coronary arteries, suggesting a mechanism of vasospasm. Cardiac magnetic resonance imaging confirmed findings of regional myocardial infarction. This case highlights a potential danger of pseudoephedrine even when used by otherwise healthy individuals.
Manini
Alex F
AF
Harvard Affiliated Emergency Medicine Residency, Harvard Medical School, Boston, MA, USA. amanini@partners.org <amanini@partners.org>
Kabrhel
Christopher
C
Thomsen
Todd W
TW
D000082:Acetaminophen / Q000008:administration & dosage; D000328:Adult; D003329:Coronary Vasospasm / Q000139:chemically induced; D004338:Drug Combinations; D004809:Ephedrine / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis; D014663:Nasal Decongestants / Q000008:administration & dosage / Q000009:adverse effects*; D004366:Nonprescription Drugs / Q000009:adverse effects; D013566:Sympathomimetics / Q000008:administration & dosage / Q000009:adverse effects*
D004338:Drug Combinations; D014663:Nasal Decongestants; D004366:Nonprescription Drugs; D013566:Sympathomimetics; D000082:Acetaminophen; D004809:Ephedrine