Sildenafil
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Cardiac arrest in a patient with a congenital coronary artery anomaly: case report A 59-year-old man with vascular-type erectile dysfunction went into cardiac arrest after taking sildenafil. The man, who had an undiagnosed congenital coronary artery anomaly (left coronary artery arising from the right sinus of Valsalva), ingested sildenafil 50mg and was found collapsed 30 minutes later, after sexual intercourse. He had ventricular fibrillation and was resuscitated at the scene. Upon admission to hospital, a 12-lead ECG showed no significant abnormalities of repolarisation, and he had elevated cardiac enzymes. Impaired left ventricular function and an ejection fraction of 46% were apparent upon echocardiogram, and coronary arteriography and angiographic CT scan revealed his coronary artery anomaly. The man subsequently underwent coronary artery bypass surgery and, after 6 months, his ventricular function had improved and his ejection fraction was 54%. Author comment: "In the present case, the combination of sildenafil-triggered vasodilation and exercise maybe caused a coronary steal phenomenon following ischemia with lethal arrhythmias . . . [and] might indicate that sildenafil as a trigger was necessary to induce a perfusion deficit." Huber BC, et al. Cardiac arrest associated with sildenafil ingestion in a patient with an abnormal origin of the left coronary artery: Case report. BMC Cardiovascular Disorders 11: No. 49, 8 Aug 2011. Available from: URL: http:// 803062166 dx.doi.org/10.1186/1471-2261-11-49 - Germany
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Reactions 5 Nov 2011 No. 1376
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