title: Zolmitriptan induced acute coronary syndrome: a unique case.
abstract: Triptans have been used for the acute treatment of migraine headaches for many years. Although their use can lead to coronary vasospasm, there are very few reports of triptans actually leading to myocardial infarction in patients with normal coronaries. We hereby present a 58-year-old man who presented to the emergency room with chest pain. Electrocardiogram demonstrated ST segment depression in the inferior leads with diffuse spasm of the distal right coronary artery seen on angiography, which was easily reversed by intracoronary nitroglycerine. We believe this is the first reported case of a patient with a myocardial infarction after taking oral zolmitriptan in which coronary angiogram clearly demonstrated coronary vasospasm reversal after intracoronary nitroglycerine. A detailed search of the literature for reported cases of myocardial infarction after triptan use is also provided.
authors.affiliation: Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. marcus-smith@ouhsc.edu
authors.forename: Marcus
authors.initials: M
authors.lastname: Smith
authors.forename: Harsh
authors.initials: H
authors.lastname: Golwala
authors.forename: Pedro
authors.initials: P
authors.lastname: Lozano
mesh_terms: D054058:Acute Coronary Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D002637:Chest Pain / Q000209:etiology; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy; D009203:Myocardial Infarction / Q000139:chemically induced / Q000175:diagnosis; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use; D023303:Oxazolidinones / Q000009:adverse effects* / Q000627:therapeutic use; D058825:Serotonin 5-HT1 Receptor Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D014363:Tryptamines / Q000009:adverse effects* / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D023303:Oxazolidinones; D058825:Serotonin 5-HT1 Receptor Agonists; D014363:Tryptamines; D014665:Vasodilator Agents; C089750:zolmitriptan; D005996:Nitroglycerin