J Korean Soc Emerg Med.  2001 Jun;12(2):176-182.

Acute Myocardial Infarction after the Use of Sildenafil Citrate(Viagra(R))

• You JY
• Wang SJ
• Cho SH

Abstract

Erectile dysfunction(ED) is defined as the inability to achieve and/or maintain an erection which is sufficient for satisfactory sexual activity. Risk factors for ED include many of the same risk factors for cardiovascular disease: hypertension; lipid abnormalities, including low high-density lipoprotein cholesterol; diabetes; and smoking. Therefore, some patients with ED will have ischemic heart disease. Viagra(R), an oral therapy for ED, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate(cGMP)-specific phosphodiesterase 5(PDE5). The adverse effects of sildenafil include headache, flushing, dyspepsia, nasal congestion, visual disturbance, and cardiovascular complications. A general impression exists that cardiovascular complications of sildenafil occur mainly when the drug is taken concomitantly with nitrate. We report the case of a 52-year-old man who developed an acute myocardial infarction shortly after taking one tablet of sildenafil without sexual activity. The patient had not been using nitrates. Physicians treating patients with chest pain should be aware of the potential consequences of giving nitrates to patients taking sildenafil. We suggest that before initiating therapy, the history of sildenafil ingestion be obtained from patients with suspected myocardial infarction.

Keyword

Erectile dysfunction; Sildenafil citrate(Viagra(R)); Acute myocardial infarction

MeSH Terms

Cardiovascular Diseases
Chest Pain
Cholesterol
Citric Acid
Dyspepsia
Eating
Erectile Dysfunction
Estrogens, Conjugated (USP)
Flushing
Guanosine
Headache
Humans
Hypertension
Lipoproteins
Male
Middle Aged
Myocardial Infarction*
Myocardial Ischemia
Nitrates
Risk Factors
Sexual Behavior
Smoke
Smoking
Sildenafil Citrate
Cholesterol
Citric Acid
Estrogens, Conjugated (USP)
Guanosine
Lipoproteins
Nitrates
Smoke