Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug 7;12(5):166-168.
doi: 10.1016/j.jccase.2015.07.003. eCollection 2015 Nov.

Nitroglycerin administration during cardiac arrest caused by coronary vasospasm secondary to misoprostol

Kent A Owusu  1 , Joseph J Brennan  2   3 , Alexander Perelman  3 , Elise Meoli  3 , Jerry Altshuler  1   4
Affiliations

Nitroglycerin administration during cardiac arrest caused by coronary vasospasm secondary to misoprostol

Kent A Owusu et al. J Cardiol Cases. .

Abstract

There have been no reports of successful resuscitation using nitroglycerin (NTG) for cardiac arrest due to definitive coronary vasospasm. A 42-year-old female was brought to the Emergency Department in ventricular fibrillation after being found collapsed with the consumption of misoprostol. NTG, a potent coronary arterial dilator, not typically used in the management of cardiac arrest, was administered after 27 min of resuscitation efforts following advanced cardiac life support. NTG aided in the return of spontaneous circulation during a ventricular fibrillation cardiac arrest in the setting of prostaglandin use. <Learning objective: Nitroglycerin is not typically employed in the management of cardiac arrest. We report successful cardiac resuscitation after administration of intravenous nitroglycerin during a prolonged cardiac arrest event secondary to coronary artery vasospasm in the setting of recent misoprostol ingestion. Nitroglycerin may have a role in cardiac arrest in the setting of coronary vasospasm.>.

Keywords: Cardiac arrest; Coronary vasospasm; Misoprostol; Myocardial infarction; Nitroglycerin.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Angiogram showing non-obstructive coronary artery disease on day of presentation. LCA, left coronary artery; RCA, right coronary artery.
Fig. 2
Fig. 2
Electrocardiogram showing ST-segment elevation in anteroseptal leads (V1–V5) on the day of presentation.
Fig. 3
Fig. 3
Electrocardiogram showing resolution of ST-segment elevation on day #2 of hospitalization.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Myerburg R.J., Kessler K.M., Mallon S.M. Life-threatening ventricular arrhythmias in patients with silent myocardial ischemia due to coronary artery spasm. N Engl J Med. 1992;326:1451–1455. - PubMed
    1. O’Connor R.E., Brady W., Brooks S.C., Diercks D., Egan J., Ghaemmaghami C., Menon V., O’Neil B.J., Travers A.H., Yannopoulos D. Part 10: acute coronary syndromes. 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(Suppl. 3):S787–S817. - PubMed
    1. Guglin M., Postler G. High dose nitroglycerin treatment in a patient with cardiac arrest: a case report. J Med Case Rep. 2009;3:8782. - PMC - PubMed
    1. Ward W.G., Reid R.L. High-dose intravenous nitroglycerin during cardiopulmonary resuscitation for refractory cardiac arrest. Am J Cardiol. 1984;53:1725. - PubMed
    1. Sueda S., Ochi N., Kawada H., Matsuda S., Hayashi Y., Tsuruoka T., Uraoka T. Frequency of provoked coronary vasospasm in patients undergoing coronary arteriography with spasm provocation test of acetylcholine. Am J Cardiol. 1999;83:1186–1190. - PubMed

LinkOut - more resources