Acute coronary artery vasospasm associated with misoprostol for termination of pregnancy.
Prostaglandin E(1) analogues, gemeprost and misoprostol, are the most widely used drugs for medical termination of pregnancy within the first two trimesters of pregnancy. Gemeprost has been reported to be associated with acute cardiovascular accidents in a few cases, but no adverse cardiovascular events have been reported with misoprostol. For this reason, misoprostol has been considered a potentially safer drug and is widely recommended as a first-choice drug in combination with mifepristone. We report a case of a 32-year-old woman with active smoking and obesity, who developed an episode of transient acute coronary artery vasospasm following the administration of intravaginal misoprostol. This report illustrates that misoprostol can also be associated with acute coronary events, although it remains to be evaluated whether the risk is similar or lower to gemeprost.
Illa
Miriam
M
Department of Maternal-Fetal Medicine, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia (ICGON), Hospital Clinic, University of Barcelona, Barcelona, Spain.
Bennasar
Mar
M
Eixarch
Elisenda
E
Berge
Raquel
R
Font
Carme
C
Palacio
Montse
M
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D000527:Alprostadil / Q000009:adverse effects / Q000031:analogs & derivatives; D000700:Analgesics / Q000627:therapeutic use; D002637:Chest Pain / Q000188:drug therapy; D003329:Coronary Vasospasm / Q000139:chemically induced / Q000175:diagnosis*; D003331:Coronary Vessels / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000031:analogs & derivatives / Q000627:therapeutic use; D015735:Mifepristone / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000187:drug effects; D014325:Tromethamine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000020:Abortifacient Agents, Nonsteroidal; D000700:Analgesics; D014325:Tromethamine; D016595:Misoprostol; D015735:Mifepristone; C021182:gemeprost; D007660:Ketoprofen; D000527:Alprostadil; C118296:dexketoprofen trometamol