Phenelzine-induced myocardial injury: a case report.

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
Adeline Su-Yin NgoKent R Olson

Abstract

Phenelzine is an irreversible monoamine oxidase inhibitor (MAOI). Hypertensive reactions after ingestion of tyramine-rich foods such as cheese are well known. However, a review of the available medical literature found no previous reports of myocardial infarction resulting from the ingestion of cheese by a patient taking a MAOI. A 34-year-old female taking phenelzine for depression developed severe chest pain 1 h after eating cheese. She was hypertensive and the electrocardiography showed ischemic changes in the antero-lateral chest leads. The chest pain and elevated blood pressure were relieved with intravenous morphine and nitroprusside. The initial serum troponin I level was normal, but serial repeat levels showed a rising trend with a peak at 4.89 ug/L (reference range <0.05 ug/L) 6 h after the initial blood draw, suggestive of a non-ST elevation myocardial infarction. The patient subsequently developed hypotension 4 h after another therapeutic dose of phenelzine was served to the patient 4 h after her admission to the ED. This was corrected with at least 2 L of intravenous normal saline boluses. Subsequent EKGs and Sestamibi scan showed no evidence of cardiac ischemia. She was discharged home after a hospital stay of 3 day...Continue Reading

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Citations

Jun 29, 2016·International Journal of Cardiology·Ines PotočnjakMiro Jakovljević
Mar 28, 2018·British Journal of Pharmacology·Christian CarpénéJean Galitzky
Aug 15, 2014·Journal of Clinical Psychopharmacology·Mohamad AlkhouliPravin Patil
Jun 20, 2020·PloS One·Mohammed ZawiahAbdullah Abdulmajid Abdo Ahmed
Aug 21, 2021·Frontiers in Cardiovascular Medicine·Anna CalviAderville Cabassi

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