Cardiac myonecrosis in hypertensive crisis associated with monoamine oxidase inhibitor therapy
Abstract
A young woman taking tranylcypromine for depression was hospitalized with severe chest pain and hypertension after eating cheese. Electrocardiography initially showed arrhythmias and precordial ST segment depression. Myocardial creatine kinase values were elevated, and echocardiography showed regional ventricular dysfunction, suggestive of focal cardiac myonecrosis. The cardiovascular pathophysiology of tyramine hypertensive crisis and related catecholamine excess states, including pheochromocytoma and clonidine withdrawal, is reviewed. Cardiac myonecrosis is a potential adverse effect of the hypertensive crisis associated with monoamine oxidase inhibitor use. Psychiatric indications for monoamine oxidase inhibitors may be expanding, but clinicians should continue to exercise caution in the use of these agents.
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Monoamine oxidase inhibitors may lead to severely elevated blood pressure in individuals who consume foods containing tyramine.
“Monoamine oxidase inhibitors may lead to severely elevated BP in individuals who consume foods containing tyramine.242,243”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [242]
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Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153 · see citing works
- Authors
- Liu, L. X., & Rustgi, A. K.
- Affiliations
- Harvard University (US)
- Corresponding author
- Liu, Leo X.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 1987-05
- Volume
- 82
- Issue
- 5
- Pages
- 1060-1064
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2085602650
- Cited by
- 9
- References
- 29
- Citations by year
- 2018: 4 · 2015: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
- Keywords
- hypertensive crisis, monoamine oxidase inhibitors, tranylcypromine, tyramine, adverse drug reactions, depression, hypertension, chest pain, ST-segment depression, pheochromocytoma, clonidine withdrawal, catecholamine excess
- MeSH terms
- Adult, Antidepressive Agents, Cheese, Female, Humans, Hypertension, Monoamine Oxidase Inhibitors, Myocardium, Necrosis, Tranylcypromine, Tyramine
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