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J Korean Soc Emerg Med > Volume 12(2); 2001 > Article
Journal of The Korean Society of Emergency Medicine 2001;12(2): 176-182.
Acute Myocardial Infarction after the Use of Sildenafil Citrate(Viagra(R))
Ji Young You, Soon Joo Wang, Sung Hoon Cho
1Department of Emergency Medicine, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Korea. jiyoung6982@hanmail.net
2Department of Emergency Medicine, Bundang Cha Hospital, Pochon Cha University College of Medicine, Korea.
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.
Key words: Erectile dysfunction, Sildenafil citrate(Viagra(R)), Acute myocardial infarction
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