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Case Reports
. 2008 Nov;24(11):e86-8.
doi: 10.1016/s0828-282x(08)70200-9.

Acute coronary syndrome presenting after pseudoephedrine use and regression with beta-blocker therapy

Serhat Akay  1 , Metehan Ozdemir
Affiliations
Case Reports

Acute coronary syndrome presenting after pseudoephedrine use and regression with beta-blocker therapy

Serhat Akay et al. Can J Cardiol. 2008 Nov.

Abstract
in English, French

Pseudoephedrine, a common ingredient in cold relief drugs, dietary supplements and Chinese herbal tea, has potent sympathomimetic effects, impacting the cardiovascular system. The chemical properties and clinical effects of pseudoephedrine are similar to those of ephedrine, and its main effect is caused by the release of endogenous norepinephrine. A 45-year-old man who presented with chest pain following ingestion of pseudoephedrine--containing prescription medication is described. The patient was initially diagnosed with inferior myocardial infarction based on an electrocardiogram, and intravenous metoprolol was started pending coronary artery angiography. Metoprolol reversed the ST segment elevation and relieved the symptoms, and coronary angiography showed normal coronary arteries. The present case highlights beta-blocker therapy as part of an initial intervention of pseudoephedrine-related cardiac symptoms.

Le pseudoéphédrine, un ingrédient que l’on trouve couramment dans les médicaments contre le rhume, les suppléments alimentaires et le thé chinois, exerce de puissants effets sympathomimétiques qui se répercutent sur l’appareil cardiovasculaire. Les propriétés chimiques et les effets cliniques de la pseudoéphédrine sont semblables à ceux de l’éphédrine et son principal effet est imputable à la libération de noradrénaline endogène. On décrit ici le cas d’un homme de 45 ans qui a consulté pour douleurs rétrosternales après avoir pris un médicament d’ordonnance renfermant de la pseudoéphédrine. Le patient a tout d’abord reçu un diagnostic d’infarctus du myocarde inférieur sur la base de l’électrocardiogramme et du métoprolol a été débuté par voie intraveineuse en attendant la coronarographie. Le métoprolol a corrigé l’élévation du segment ST et soulagé les symptômes, et la coronarographie a révélé des artères normales. Ce cas illustre l’utilité du bêta-blocage dans le cadre d’une intervention initiale pour corriger les symptômes cardiaques liés à la pseudoéphédrine.

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Figures

Figure 1)
Figure 1)
The first electrocardiogram after admission of the patient to the emergency department
See this image and copyright information in PMC

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