Triptans and troponin: a case report.
This case report describes for the first time acute coronary syndrome in a 67-year old patient after oral intake of naratriptan for migraine. So far in the literature, only sumatriptan, zolmitriptan and frovatriptan have been described to cause acute coronary syndromes. A 67-year old Swiss woman with thoracic pain after intake of 2.5 mg naratriptan presented with T-wave inversions in the ECG and a positive troponin-T at our hospital. Coronary angiography showed normal coronary arteries. Naratriptan-induced coronary vasospasms were thought to have caused the acute coronary syndrome.Triptans should not be prescribed in patients with pre-existing coronary heart disease. However, triptans can also cause acute coronary syndromes in patients without coronary heart disease--as described in our case report. Severe or persistent thoracic pain after intake of triptans should therefore be investigated accordingly.
Weder
Claudia R
CR
Department of Internal Medicine, University Hospital of Zürich, Rämistrasse 100, CH-8091 Zürich, Switzerland. claudia.weder@usz.ch
Schneemann
Markus
M
D054058:Acute Coronary Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018490:Serotonin Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*; D014363:Tryptamines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D010880:Piperidines; D018490:Serotonin Agents; D020107:Troponin T; D014363:Tryptamines; C106783:naratriptan