sildenafil-citrate and Acute-Coronary-Syndrome

Despite significant advances in medicine, mortality due to cardiovascular disease is not yet preventable. We investigated the amounts of elabela (ELA) and apelin, synthesized by cardiomyocytes, and changes of these compounds in cardiac tissue and circulation after administration of iloprost (ILO) and sildenafil (SIL) in rats with induced myocardial ischemia (MI). We also investigated a connection with circulating troponin-I, creatine kinase (CK), creatine kinase-myocardial band (CK-MB) and nitric oxide (NO), and total anti-oxidant (TAS)/total oxidant status (TOS). We established eight study groups of five rats each. Group 1, sham, was given only physiologic serum; group 2, ILO; group 3, SIL; group 4, ILO + SIL; group 5, MI; group 6, MI + ILO; group 7, MI + SIL; group 8, MI + ILO + SIL. Troponin-I, CK, CK-MB and TAS-TOS were investigated using an autoanalyzer. NO, ELA and apelin were analyzed by ELISA. Tissue apelin and ELA expressions and localizations were determined by immunohistochemistry. The MI group compared to the control (sham) group showed that ELA, apelin, troponin-I, CK, CK-MB, NO and TOS levels were elevated significantly. Concentrations of these factors increased in MI, but decreased after ILO and SIL administration. The largest decrease of TOS was identified in the ILO + SIL group. ELA and apelin may be novel indicators of MI and administration of ILO and SIL, individually or together, may be useful for treating MI.

Topics: Acute Coronary Syndrome; Animals; Antioxidants; Biomarkers; Creatine Kinase; Iloprost; Male; Myocardial Infarction; Nitric Oxide; Rats, Sprague-Dawley; Sildenafil Citrate

A 73-year-old male suffers a type-2 inferior myocardial infarction and is found unconscious, hypotensive and centrally cyanotic. His arterial blood gas analysis shows a chocolate-brown discoloration, with pO2 45.1 kPa, HbO2 48.9%, MetHb 51%, BE -9 and a lactate of 3.7 mmol/l. Administration of 200 mg of methylene blue intravenously, normalizes the patient's abnormalities. His life-threatening acquired methaemoglobinaemia appears secondary to under-the-counter viagra.

Topics: Acute Coronary Syndrome; Aged; Humans; Male; Methemoglobinemia; Methylene Blue; Sildenafil Citrate

Sildenafil is a drug used for male erectile dysfunction. Sildenafil's fatal cardiac effects except due to hypotension with simultaneous nitrate use have not been reported.We reported in this case a 70-year-old man admitted to the emergency service with chest pain, which occurs in an hour after sildenafil use. Electrocardiogram showed inferoposterior ST-segment elevation. In angiography, total circumflex artery occlusion has been seen.

Topics: Acute Coronary Syndrome; Aged; Chest Pain; Coronary Angiography; Electrocardiography; Emergency Service, Hospital; Humans; Male; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Sildenafil Citrate; Sulfones

Topics: Acute Coronary Syndrome; Adult; Coronary Angiography; Diagnosis, Differential; Electrocardiography; Humans; Male; Marijuana Smoking; Myocardial Bridging; Piperazines; Purines; Sildenafil Citrate; Sulfonamides; Vasodilator Agents