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Myocardial infarction associated with the administration of intravenous ephedrine and metaraminol for spinal‐induced hypotension
Author(s) -
Khavandi A.,
Gatward J. J.,
Whitaker J.,
Walker P.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2008.05832.x
Subject(s) - medicine , metaraminol , ephedrine , anesthesia , myocardial infarction , cardiology , blood pressure
Summary A 31‐year‐old female with no risk factors for cardiac disease suffered a peri‐operative myocardial infarction during an elective gynaecological procedure under spinal anaesthesia. The timing and nature of cardiac symptoms suggest that the myocardial infarction was caused by coronary artery vasospasm secondary to ephedrine and/or metaraminol, which were administered to treat spinal‐induced hypotension. We review the recent literature and case reports on myocardial infarction attributed to sympathomimetic drugs, and recommend the use of sublingual or intravenous nitrates when signs or symptoms of coronary arterial vasospasm become evident during their use.