Zolmitriptan-induced acute myocardial infarction.
Triptans are an established treatment for acute migraine attacks. By activating 5HT1B/1D receptors they lead to vasoconstriction of the cerebral blood vessels which are dilated during migraine attacks. Moreover, they reduce secretion of vasoactive peptides and conduction of pain stimuli over the cerebral cortex. In up to 7% of cases of treatment with triptans, thoracic pain occurs, although this is mostly transient, mild and without lasting ischemia. We present the case of a 45 year-old woman with a history of migraine with visual aura since the age of 20. She had no history of diabetes mellitus, hypertension, smoking or any other risk factors for cardiovascular events before she was admitted to our emergency room with typical chest pain. An electrocardiogram revealed anterior myocardial infarction following her monthly dose of oral zolmitriptan. Catherization revealed a normal coronary arterial system. The laboratory indices for cardiac risk were within normal ranges. The patient was advised to avoid triptans permanently on being discharged.
Ankara Numune Education and Research Hospital, Department of Cardiology, Talatpasa Bulvari, Sihhiye, Ankara, Turkey. koroner80@gmail.com
Ibrahim
I
Kocaoglu
Serkan
S
Gökaslan
Ahmet
A
Karagöz
Deniz
D
Sahin
Özgül
Ö
Ucar
Sinan
S
Aydogdu
D000284:Administration, Oral; D056988:Anterior Wall Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D020325:Migraine with Aura / Q000188:drug therapy*; D023303:Oxazolidinones / Q000008:administration & dosage / Q000009:adverse effects*; D058825:Serotonin 5-HT1 Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D014363:Tryptamines / Q000008:administration & dosage / Q000009:adverse effects*
D023303:Oxazolidinones; D058825:Serotonin 5-HT1 Receptor Agonists; D014363:Tryptamines; C089750:zolmitriptan