title: Myocardial infarction induced by oral terazosin in a patient with predisposing structural cardiomyopathy: case report.
abstract: We describe a 71-year-old male patient who developed acute myocardial infarction (AMI) due to a dynamic left ventricular outflow tract obstruction induced by terazosin. After receiving terazosin, the patient had a syncope followed by angina. The electrocardiogram showed Q waves and ST segment elevation in the precordial and inferior leads. Coronary angiography evidenced a chronically occluded left anterior descending artery. Doppler-echocardiography revealed apical akinesia, hyperdynamic basal segments, systolic anterior motion of the mitral valve (SAM) and dynamic left ventricular outflow tract obstruction. Therapy with intravenous fluids and atenolol resulted in marked clinical improvement. Acute myocardial infarction resulted from low coronary perfusion pressure in a patient with a chronically diminished coronary reserve.
authors.affiliation: Centro Cardiovascular Universitario, Cardiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay. Address: Hospital de Clínicas, Departamento de Cardiología, Avenida Italia, Sin Número, Montevideo, Uruguay. Email: dralejandrovidal@gmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Vidal Margenat
authors.affiliation: Centro Cardiovascular Universitario, Cardiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: Federico
authors.initials: F
authors.lastname: Ferrando-Castagnetto
authors.affiliation: Centro Cardiovascular Universitario, Cardiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: Fabián
authors.initials: F
authors.lastname: Martínez
authors.affiliation: Centro Cardiovascular Universitario, Cardiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: Natalia
authors.initials: N
authors.lastname: Lluberas
authors.affiliation: Centro Cardiovascular Universitario, Cardiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vignolo
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D000787:Angina Pectoris / Q000139:chemically induced; D009202:Cardiomyopathies / Q000150:complications*; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000209:etiology; D011224:Prazosin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013575:Syncope / Q000139:chemically induced; D014694:Ventricular Outflow Obstruction / Q000139:chemically induced / Q000150:complications
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; C041226:Terazosin; D011224:Prazosin
keywords: cardiomyopathy; left ventricular outflow obstruction; myocardial infarction; terazosin