Case Report: Hypoglycaemia-induced myocardial infarction as a result of sulphonylurea misuse.
Corley, B T Davenport, C Delaney, L Hatunic, M Smith, D
Corley, B T
Davenport, C
Delaney, L
Hatunic, M
Smith, D
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2010-12-24
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Abstract
Background Recent large-scale randomized trials of intensive therapy in Type 2 diabetes have reported increased cardiovascular morbidity and mortality in patient populations who experience a high frequency of hypoglycaemic events. However, there are few descriptions of hypoglycaemia leading directly to a myocardial infarct in the medical literature to date. Case report In this article we describe the case of a 76-year-old woman without diabetes who presented with symptoms, left bundle branch block and raised troponin, indicative of a myocardial infarction. She was also noted to be hypoglycaemic with a plasma glucose level of 2.5 mmol/l. It was subsequently discovered that she had mistakenly been dispensed glibenclamide, a long-acting sulphonylurea, in the preceding weeks. Her cardiac symptoms resolved completely upon treatment of her hypoglycaemia and she had no significant coronary artery disease on angiography. Conclusion This is the first case of sulphonylurea-induced myocardial infarct in a patient without diabetes and illustrates the adverse effects of acute hypoglycaemia upon the cardiovascular system.
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1464-5491
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DOI
10.1111/j.1464-5491.2010.03226.x
PMID
21204965