Middle cerebral artery infarction associated with sildenafil citrate (Viagra) use.

Yıl 2021, Cilt: 12 Sayı: 1, 25 - 27, 18.03.2021

Hilal Sipahioğlu , Kadir Bulut Aliye Esmaoğlu

https://doi.org/10.33706/jemcr.830139

Cited By: 1

Öz

İntroduction: Sildenafil is a phosphodiesterase 5 enzyme inhibitor used in the treatment of erectile dysfunction and pulmonary hypertension. The use of sildenafil with nitrates is well known to cause myocardial ischemia. However, patients with a history of hypotension, arrhythmia, previous myocardial infarction, or stroke should be given sildenafil carefully. A few cases have been reported in the literature related to ischemic stroke and transient ischemic attack due to sildenafil use.
Case report: We report a case of middle cerebral artery (MCA) infarction after two tablets sildenafil in a 57-year-old male patient with no underlying disease. In the diffusion MRI (magnetic resonance imaging) imaging of the patient, acute diffusion limitation was observed in the left frontal lobe and parietal lobe starting from the centrum semiovale level and also in the MCA supply area affecting the medial section of the temporal lobe. We believe that this infarction is caused by the development of severe hypotension due to alcohol use with sildenafil.
Conclusion: Not only availability of hypotension, history of MI and stroke, health care providers should also give attention prescribing sildenafil in the case of cigarette and alcohol use.

Anahtar Kelimeler

Sildenafil,, ischemic stroke, hypotension

Kaynakça

• References 1) Zusman RM, Morales A, Glasser DB, Osterloh IH. Overall cardiovascular profile of sildenafil citrate. American Journal of Cardiology 1999; 83: 35C–44C
• 2) Zusman RM, Morales A, Glasser DB, Osterloh IH. Overall cardiovascular profile of sildenafil citrate. Am J Cardiol 1999;83:35C–44C.
• 3)Beavo JA. Cyclic nucleotide phosphodiesterase: functional implications of multiple isoforms. Physiological Reviews 1995; 75: 725–748
• 4)Cheitlin MD, Hutter AM Jr, Brindis RG, et al. Use of sildenafil (VIAGRA) in patients with cardiovascular disease: ACC/AHA expert consensus document. Circulation 1999;99:168–177. 5) Zusman RM, Morales A, Glasser DB, Osterloh IH. Overall cardiovascular profile of sildenafil citrate. Am J Cardiol 1999;83:35C–44C.
• 6)KimKK,KimDG,KuYHet al.Bilateralcerebral hemispheric infarction associated with sildenafil citrate (Viagra) use. Eur J Neurol 2008; 15:306–8.
• 7)Stefanovic-Budimkic M, Jovanovic DR, Beslac-Bumbasirevic L, Ercegovac MD. Recurrent ischemic stroke associated with sildenafil and tadalafil use in a young adult. Clin Neurol Neurosurg 2012; 114:405–7.
• 8)Morgan JC, Alhatou M, Oberlies J, Johnston KC. Transient ischemic attack and stroke associated with sildenafil (Viagra) use. Neurology 2001; 57:1730
• 9). Morgan JC, Alhatou M, Oberlies J, Johnston KC. Transient ischemic attack and stroke associated with sildenafil (Viagra) use. Neurology 2001; 57: 1730–1731
• 10).Tripathi A, ODonnell NP. Branch retinal artery occlusion: another complication of sildenafil. British Journal of Ophthalmology 2000; 84: 934–935. 14.
• 11). Egan RA, Pomeranz H. Transient ischemic attack and stroke associated with sildenafil (Viagra) use. Neurology 2002; 59: 293–294
• 12)Awan GM, Balderon E, Dawood G, Alpert M. Acute, symptomatic atrial fibrillation after sildenafil citrate therapy in a patient with hypertrophic obstructive cardiomyopathy. American Jorunal of Medical Sciences 2000; 320: 69–71
• 13) Cheitlin MD, Hutter AM Jr, Brindis RG, et al. Use of sildenafil (Viagra) in patients with cardiovascular disease. Technology and Practice Executive Committee. Circulation 1999; 99: 168–177.
• 14) Koner RA. Sex and the patients with cardiovascular risk factors: focus on sildenafil. American Journal of Medicine 2000; 19: 13S–21S.