title: Under-the-counter acquired acute coronary syndrome: Methaemoglobinaemia.
abstract: A 73-year-old male suffers a type-2 inferior myocardial infarction and is found unconscious, hypotensive and centrally cyanotic. His arterial blood gas analysis shows a chocolate-brown discoloration, with pO2 45.1 kPa, HbO2 48.9%, MetHb 51%, BE -9 and a lactate of 3.7 mmol/l. Administration of 200 mg of methylene blue intravenously, normalizes the patient's abnormalities. His life-threatening acquired methaemoglobinaemia appears secondary to under-the-counter viagra.
authors.affiliation: Department of Intensive Care Medicine, Maastricht University Medical Centre, the Netherlands l.mommers@mumc.nl.
authors.forename: Lars
authors.initials: L
authors.lastname: Mommers
authors.affiliation: Department of Intensive Care Medicine, Maastricht University Medical Centre, the Netherlands.|Department of Cardiology, Maastricht University Medical Centre, the Netherlands.
authors.forename: Thijs Sr
authors.initials: TS
authors.lastname: Delnoij
authors.affiliation: Department of Intensive Care Medicine, Maastricht University Medical Centre, the Netherlands.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Strauch
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood; D000368:Aged; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000188:drug therapy / Q000209:etiology*; D008751:Methylene Blue / Q000008:administration & dosage*; D000068677:Sildenafil Citrate / Q000009:adverse effects*
chemical_list: D000068677:Sildenafil Citrate; D008751:Methylene Blue
keywords: Methaemoglobinaemia; acute coronary syndrome; under-the-counter medication; viagra