STEMI in a 24-year-old man after use of a synephrine-containing dietary supplement: A case report and review of the literature

Texas Heart Institute Journal

Volumn 36, Issue 6, 2009, Pages 586-590

  Thomas, John E ^a   Munir, Jamalah A ^a   McIntyre, Peter Z ^a   Ferguson, Michael A ^a,b  

^a WALTER REED ARMY MEDICAL CENTER   (United States)

^b UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES   (United States)

Author keywords

Citrus adverse effects; Coronary vasospasm complications etiology; Dietary supplements adverse effects poisoning; Myocardial infarction chemically induced; Plant preparations; Synephrine; United States Food and Drug Administration; Weight loss drug effects

Indexed keywords

3 HYDROXY 3 METHYLGLUTARYL COENZYME A; ACETYLSALICYLIC ACID; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CREATINE KINASE MB; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DRUG DERIVATIVE; ENOXAPARIN; EPTIFIBATIDE; GLYCERYL TRINITRATE; HEPARIN; MORPHINE; NUTREX LIPO 6X; OXEDRINE; TROPONIN I; UNCLASSIFIED DRUG; WEIGHT LOSS DRUG;

ADULT; AEROBIC EXERCISE; ANGIOCARDIOGRAPHY; ANXIETY; ARTICLE; CARDIOVASCULAR RISK; CASE REPORT; CHEMICAL COMPOSITION; CIGARETTE SMOKING; CORONARY ARTERY THROMBOSIS; DIABETES MELLITUS; DIAPHORESIS; DIET SUPPLEMENTATION; DISEASE COURSE; DRUG MECHANISM; DRUG SAFETY; DYSPNEA; ELECTROCARDIOGRAM; FOLLOW UP; FOOD AND DRUG ADMINISTRATION; HEART AUSCULTATION; HEART INFARCTION; HUMAN; HYPERLIPIDEMIA; HYPERTENSION; HYPOKINESIA; LEFT ANTERIOR DESCENDING CORONARY ARTERY; MALE; PALPATION; PERICARDIAL EFFUSION; SINUS BRADYCARDIA; ST SEGMENT ELEVATION; THORAX PAIN; VOMITING; WEIGHT REDUCTION;

ADRENERGIC ALPHA-AGONISTS; ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY; CARDIOVASCULAR AGENTS; CORONARY ANGIOGRAPHY; CORONARY THROMBOSIS; DIETARY SUPPLEMENTS; ELECTROCARDIOGRAPHY; HUMANS; MALE; MYOCARDIAL INFARCTION; SYNEPHRINE; TREATMENT OUTCOME; YOUNG ADULT;

EID: 76149104584     PISSN: 07302347     EISSN: 15266702     Source Type: Journal    
DOI: None     Document Type: Article

References (8)

1. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343(25): 1833-8.
2. Samenuk D, Link MS, Homoud MK, Contreras R, Theoharides TC, Wang PJ, Estes NA 3rd. Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine. Mayo Clin Proc 2002;77(1):12-6.
3. Shekelle P, Hardy ML, Morton SC, Maglione M, Suttorp M, Roth E, et al. Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects. Evid Rep Technol Assess (Summ) 2003;(76):1-4.
4. Sales of Supplements Containing Ephedrine Alkaloids (Ephedra) Prohibited [cited 2009 Oct 13]. Available from: http://www.fda.gov/Food/DietarySupplements/ Guidance-ComplianceRegulatoryInformation/RegulationsLaws/ucm079733.htm
5. Vincent GM, Anderson JL, Marshall HW. Coronary spasm producing coronary thrombosis and myocardial infarction. N Engl J Med 1983;309(4):220-3.
6. Jordan S, Murty M, Pilon K. Products containing bitter orange or synephrine: suspected cardiovascular adverse reactions. Canadian Adverse Reaction Newsletter 2004;14(4):3-4.
7. Bitter orange (Citrus aurantium var. amara) extracts and constituents (±)-p-synephrine [CAS No. 94-07-5] and (±)-p-octopamine [CAS No. 104-143]. Review of Toxicological Literature. Contract No. N01-ES-35515. National Toxicology Program: June 2004. p. 1-73. Available from: http://ntp.niehs.nih.gov/ntp/htdocs/Chem-Background/ ExSumPdf/Bitterorange.pdf
8. Nykamp DL, Fackih MN, Compton AL. Possible association of acute lateral-wall myocardial infarction and bitter orange supplement. Ann Pharmacother 2004;38(5):812-6.