title: Hypoglycaemia-induced myocardial infarction as a result of sulphonylurea misuse.
abstract: BACKGROUND
  Recent large-scale randomized trials of intensive therapy in Type 2 diabetes have reported increased cardiovascular morbidity and mortality in patient populations who experience a high frequency of hypoglycaemic events. However, there are few descriptions of hypoglycaemia leading directly to a myocardial infarction (MI) in the medical literature to date.
  
  
  METHODS
  In this article we describe the case of a 76-year-old woman without diabetes who presented with symptoms, left bundle branch block and raised troponin, indicative of an MI. She was also noted to be hypoglycaemic with a plasma glucose level of 2.5 mmol/l. It was subsequently discovered that she had mistakenly been dispensed glibenclamide, a long-acting sulphonylurea, in the preceding weeks. Her cardiac symptoms resolved completely upon treatment of her hypoglycaemia and she had no significant coronary artery disease on angiography.
  
  
  CONCLUSIONS
  This is the first case of sulphonylurea-induced MI in a patient without diabetes and illustrates the adverse effects of acute hypoglycaemia upon the cardiovascular system.
authors.affiliation: Department of Endocrinology, Beaumont Hospital, Dublin, Ireland. diarmuidsmith@beaumont.ie
authors.forename: B T
authors.initials: BT
authors.lastname: Corley
authors.forename: C
authors.initials: C
authors.lastname: Davenport
authors.forename: L
authors.initials: L
authors.lastname: Delaney
authors.forename: M
authors.initials: M
authors.lastname: Hatunic
authors.forename: D
authors.initials: D
authors.lastname: Smith
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000139:chemically induced / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000150:complications / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000139:chemically induced / Q000209:etiology / Q000503:physiopathology*; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D013453:Sulfonylurea Compounds