Cardiac Manifestations Following Ergotamine Tartrate Therapy for Migraine

Since the isolation of ergotamine tartrate by Stoll¹in 1918, enormous quantities have been used clinically. All available reports, analyzed by von Storch²for untoward effects of ergotamine tartrate therapy, revealed only forty-two serious sequelae, including eight fatal cases. Twenty-three occurred in obstetric cases, eleven in thyrotoxicosis and eight in miscellaneous disorders. This review also revealed that overdosage, and/or associated sepsis, obliterative vascular disease and/or cardiovascular disease play an important role in the production of ill effects. Death occurred in only one case³unassociated with any of these factors. Cardiovascular disease as a contributing factor is emphasized by Zimmermann,⁴who reported that a patient having anginal attacks was given one 0.5 mg. dose subcutaneously and died an anginal death. Labbé⁵gave a patient with organic heart disease a 0.5 mg. dose subcutaneously, daily for three days, with angina three hours after each dose and hemiplegia