Acute Myocardial Infarction With Sumatriptan: A Case Report and Review of the Literature

Chalaupka, Flavio Devetag

doi:10.1111/j.1526-4610.2009.01409.x

Cited by 18 publications

(13 citation statements)

References 12 publications

(12 reference statements)

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“…[19][20][21][22] In a review in 2009, 21 cases were described in which a cardiac event occurred after oralor subcutaneous injection of triptans. 23 In many of these events, however, the time of the cardiac event was outside the therapeutic window (5 half-lives) of the triptan in question.…”

Section: Migraine and Coronary Heart Diseasementioning

confidence: 99%

The Risks or Lack Thereof of Migraine Treatments in Vascular Disease

Diener

2020

Headache

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Premises Patients with migraine have a co‐morbidity with vascular diseases such as hypertension, coronary heart disease, and stroke. Problem This overview gives recommendations for the therapy of acute migraine attacks and for migraine prevention in patients with vascular diseases. In particular, the use of triptans in patients with vascular diseases is discussed. Potential Solutions Currently, there is a contraindication for the use of the triptans in patients with vascular disease, although there is no evidence that triptans increase the risk of heart attacks or stroke.

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Section: Migraine and Coronary Heart Diseasementioning

confidence: 99%

The Risks or Lack Thereof of Migraine Treatments in Vascular Disease

Diener

2020

Headache

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“…However, since the expected treatment regimen for acute migraines only involves the ED setting, no such events have been reported [22]. In contrast to other recommended treatments, the adverse effect profile of metoclopramide is less worrisome than that of triptans (hypertensive crisis and myocardial infarction), which is also highly used in the ED setting [23-24]. Studies have also shown that the dose of metoclopramide necessary to achieve 48 hours of sustained freedom from pain was no different in patients receiving 10, 20, or 40 mg; thus, the smallest dose of 10 mg, plus 25 mg of diphenhydramine (dyskinesia prophylaxis), is effective in treating acute migraines [20].…”

Section: Reviewmentioning

confidence: 99%

Metoclopramide for Acute Migraine Treatment in the Emergency Department: An Effective Alternative to Opioids

Najjar

Hall

Estupiñan

2017

Cureus

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In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings. Our literature review demonstrates that metoclopramide should be used more frequently as first-line therapy for an acute migraine over opioids. The use of opioids specifically has been discouraged as migraine treatment by the American Headache Society citing “insufficient evidence” as the main reason. Metoclopramide, specifically using the 10 mg dose, has been cited as “highly likely to be effective” by the same guidelines. Another major issue with opioids is the growing potential for abuse, thus minimizing the use of these drugs for only special circumstances would be beneficial overall.

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“…He had had no personal or family history of cardiovascular disease or risk factors for it, but coronary angiography revealed total occlusion of the left anterior descending artery (LAD) 32 . Another patient suffered an acute MI while using sumatriptan who was found to have normal coronary arteries at cardiac catheterization 33 . These, arguably, are just 2 isolated cases, but there are not large numbers of patients with cardiovascular events while on headache medications to investigate.…”

Section: The Role Of Cardiovascular Screening In Headache Patientsmentioning

confidence: 99%

The Role of Cardiovascular Screening in Headache Patients

Kirkham

Colon²,

Solomon³

2011

Headache: The Journal of Head and Face Pain

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There have been associations demonstrated between migraine and ischemic stroke and heart disease. Additionally, headache patients have increased cardiovascular risk factors. This article reviews available data supporting these concerns and answers the following questions: 1) Does the association between migraine and cardiovascular disease warrant cardiovascular screening tests in migraine sufferers? There is enough observational data to conclude that migraine with aura is a risk factor for cardiovascular disease. With the available data, we cannot recommend any additional cardiovascular screening tests for migraine patients. 2) Are there specific risk modification approaches for headache patients? As there is no data to suggest that migraine is a modifiable risk factor, no additional cardiovascular interventions beyond the standard practice of treating modifiable risk factors are suggested for migraine sufferers. 3) What is the appropriate screening for patients who may be candidates for triptans or tricyclic antidepressants? We support screening headache patients by obtaining a history of prior cardiovascular disease and traditional cardiovascular disease risk factors. We have found no data to suggest that any non-invasive cardiovascular screening test will identify a population of migraine sufferers at high risk for cardiovascular events following triptan use. Due to the increased risk of cardiovascular toxicity, ECGs should be considered prior to initiating tricyclic antidepressants in patients with preexisting cardiovascular disease.

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Acute Myocardial Infarction With Sumatriptan: A Case Report and Review of the Literature

Cited by 18 publications

References 12 publications

The Risks or Lack Thereof of Migraine Treatments in Vascular Disease

The Risks or Lack Thereof of Migraine Treatments in Vascular Disease

Metoclopramide for Acute Migraine Treatment in the Emergency Department: An Effective Alternative to Opioids

The Role of Cardiovascular Screening in Headache Patients

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