title: Sildenafil-associated coronary thrombosis in a patient with angiographically normal coronary arteries: a case report with review of literature.
abstract: Sildenafil is widely used as a primary pharmacological treatment of erectile dysfunction in men with and without underlying cardiovascular disease. Although initial reports of adverse cardiac events were reported soon after Food and Drug Administration approval of this agent, a large body of data suggests that sildenafil does not significantly increase the risk of nonfatal myocardial infarction, stroke, or cardiovascular deaths in patients with preexisting ischemic heart disease. We report the case of a 66-year-old man who developed thrombotic occlusion of the left anterior descending artery and presented with acute myocardial infarction after the use of sildenafil. The patient had presented with chest pain syndrome and borderline elevation of serum troponin I levels 1 week before sildenafil use, and a coronary angiogram had demonstrated normal coronary arteries. This case emphasizes the potential of precipitating coronary thrombosis in patients with unstable plaque after sildenafil use, even in patients with angiographically normal coronary arteries.
authors.affiliation: Department of Medicine, Rosalind Franklin University of Medicine and Science, Mount Sinai Hospital Medical, Chicago, IL 60608, USA.
authors.forename: Sandeep A
authors.initials: SA
authors.lastname: Saha
authors.forename: Brendan
authors.initials: B
authors.lastname: O'Cochlain
authors.forename: Amardeep
authors.initials: A
authors.lastname: Singh
authors.forename: Sandeep
authors.initials: S
authors.lastname: Khosla
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000139:chemically induced*; D003331:Coronary Vessels / Q000502:physiology; D004562:Electrocardiography; D007172:Erectile Dysfunction / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D015912:Thrombolytic Therapy; D019210:Troponin I / Q000097:blood
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D019210:Troponin I; D000068677:Sildenafil Citrate