Why the study?
Misoprostol can cause coronary artery vasospasm leading to MINOCA, but this rare cardiac adverse effect warrants awareness, especially in patients with cardiovascular risk factors.
Can high-dose misoprostol induce coronary vasospasm and MINOCA in patients with cardiovascular risk factors?
Can high-dose misoprostol induce coronary vasospasm and MINOCA in patients with cardiovascular risk factors?
Answers are grounded in this paper and cite their sources.
High-dose misoprostol can induce severe coronary vasospasm leading to MINOCA, highlighting the need for caution and close monitoring when prescribing to patients with cardiovascular risk factors.
Coronary artery vasospasm (CVS), an uncommon cause of acute chest pain, can be provoked by vasoconstriction-induced medications. Misoprostol, a prostaglandin analog, is a safe medication to terminate a pregnancy. However, misoprostol can cause coronary artery vasospasm due to vasoconstrictor properties, leading to acute myocardial infarction with nonobstructive coronary arteries (MINOCA), especially in patients with a high risk for cardiovascular disease. We report a case of a 42-year-old female with a past medical history of hypertension who presented with ST-elevation myocardial infarction following the administration of a high-dose Misoprostol. The fact that coronary angiogram and intravascular ultrasound revealed normal coronary arteries suggested transient coronary vasospasm. CVS is a severe but rare cardiac adverse effect associated with high-dose misoprostol. This medication should be prescribed with caution and close monitoring, especially in those with pre-existing heart disease or cardiovascular risk factors. Our case raises awareness of severe cardiovascular complications that can be related to using misoprostol in high-risk patients.
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Hau et al. (2023) studied this question.
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