J Korean Soc Emerg Med.  2024 Oct;35(5):372-375.

A patient who developed acute myocardial infarction after taking sildenafil: a case report

• Cho Y
• Yeo IH

Abstract

Sildenafil acts as a selective inhibitor of cyclic guanosine monophosphate-specific phosphodiesterase type 5 causes smooth muscle relaxation and vasodilatation, and enhances penile erection. Sildenafil can reduce blood pressure and possibly myocardial infarction by aggravating hypotension induced by nitric oxide. In addition, sildenafil use combined with physical exertion and the emotional stress of sexual intercourse might trigger coronary plaque rupture and acute myocardial infarction (AMI) in patients with asymptomatic coronary artery disease independently of nitrate intake. This case study concerns a patient with acute myocardial infarction who went into cardiac arrest (ventricular fibrillation) after visiting an emergency department with chest pain that started 10 minutes after taking sildenafil without sexual activity. There were no underlying diseases and no history of drug use or relevant family history. Emergency physicians should be aware that AMI may occur after taking sildenafil in previously healthy patients and be especially careful when patients are elderly. In addition, when treating patients with chest pain in the emergency department, it is important to check whether sildenafil has been used.

Keyword

Sildenafil citrate; Myocardial infarction; Heart arrest; Ventricular fibrillation