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[口服溴隐亭可能诱发急性心肌梗死:一例报告]

[Acute myocardial infarction probably induced by the oral administration of bromocriptine: a case report].

作者信息

Hara M, Takakura T, Nanimatsu K, Maeda T, Nakagawa M, Tamura M, Koumatsu K, Inoue K, Saikawa T, Ito S

机构信息

First Department of Internal Medicine, Medical College of Oita.

出版信息

J Cardiol. 1989 Jun;19(2):609-14.

PMID:2636638
Abstract

This is a report of a case of acute myocardial infarction which was probably induced by the oral administration of bromocriptine. A 55-year-old man was admitted because of suspected hypothyroidism and dwarfism. The endocrinological examination revealed primary hypothyroidism, and levothyroxine sodium replacement therapy was started. Nine days later, the bromocriptine test was performed for dwarfism. Two hours after the oral administration of 2.5 mg bromocriptine, he had severe chest pain associated with loss of consciousness and hypotension. His electrocardiogram showed marked ST depression and T wave inversion, but no abnormal Q waves. Serial myocardial enzymes and electrocardiograms confirmed acute non-transmural myocardial infarction. During coronary angiography performed about three months later, coronary arterial spasm was induced by the intravenous administration of ergonovine maleate. This experience suggests that bromocriptine, a derivative of ergot alkaloids, can cause coronary arterial spasm, and subsequent myocardial infarction. To our knowledge, bromocriptine-induced myocardial infarction has not been previously reported in Japan.

摘要

本文报告一例可能由口服溴隐亭诱发的急性心肌梗死病例。一名55岁男性因疑似甲状腺功能减退和侏儒症入院。内分泌检查显示原发性甲状腺功能减退,并开始进行左甲状腺素钠替代治疗。九天后,针对侏儒症进行了溴隐亭试验。口服2.5毫克溴隐亭两小时后,他出现严重胸痛,伴有意识丧失和低血压。其心电图显示明显的ST段压低和T波倒置,但无异常Q波。系列心肌酶和心电图检查证实为急性非透壁性心肌梗死。大约三个月后进行冠状动脉造影时,静脉注射马来酸麦角新碱诱发了冠状动脉痉挛。这一经历表明,麦角生物碱衍生物溴隐亭可导致冠状动脉痉挛,进而引发心肌梗死。据我们所知,溴隐亭诱发的心肌梗死此前在日本尚未见报道。

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