1. Methylergometrine-Induced Myocardial Infarction in the Setting of a Cesarean Delivery
- Author
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Joshua Younger, Branden Buffington, Mohamed Fayed, Ami Y Attali, and Rowaa Ibrahim
- Subjects
Methylergometrine ,business.industry ,methylergometrine ,General Engineering ,Cardiology ,non-stemi ,medicine.disease ,uterine atony ,Anesthesiology ,Anesthesia ,obstetric anesthesia ,non-st-elevation myocardial infarction ,cardiogenic pulmonary edema ,medicine ,cardiovascular system ,Obstetrics/Gynecology ,obstetric hemorrhage ,Myocardial infarction ,cardiovascular diseases ,Cesarean delivery ,postpartum pulmonary edema ,business ,c-section ,medicine.drug ,methylergonovine - Abstract
A 30-year-old female with no significant past medical history presented to our labor and delivery ward for induction of labor. Due to failure to progress, she was proceeded to cesarean delivery. Intraoperatively, it was noted that her uterus was hypotonic; she required supplemental methylergometrine to control the bleeding from the uterine atony. However, within three minutes of intramuscular (IM) administration, she complained of chest pain. She then subsequently developed pulmonary edema in the postoperative care unit, which required supplemental oxygen. She was found to have elevated troponin and brain natriuretic peptide (BNP), along with radiologic features of fluid overload suggestive of congestive cardiac failure, which all lead to the diagnosis of non-ST myocardial infarction. The patient had a normal computed tomography (CT) pulmonary angiogram, echocardiogram, and serial electrocardiograms (ECGs). She was successfully discharged from the hospital on postoperative day 4 with resolution of her symptoms and improving cardiac enzymes. Cardiology outpatient follow-up was arranged.
- Published
- 2021