Atrial fibrillation: a rare but probable adverse effect of sildenafil

Knowledge of the cardiovascular effects of sildenafil is important for a number of reasons. The main risk factors for the erectile dysfunction (hypercholesterolemia, hypertension, diabetes, smoking) are the same as those for coronary artery disease. The reported cardiovascular side effects of sildenafil in normal healthy population are minor and mainly associated with vasodialation (i.e. headache, flushing and small decrease in systolic and diastolic blood pressure). Authors report the occurrence of atrial fibrillation after the use of sildenafil in a normal healthy individual. To the best of our knowledge, there are only few case reports in the literature showing occurrence of atrial fibrillation with use of sildenafil.

Acute ST elevation myocardial infarction after intravenous immunoglobulin infusion in a young patient: a rare but probable adverse effect of immunoglobulin.

Intravenous immunoglobulin (IVIG) is used in the treatment of a variety of disorders, including autoimmune conditions. IVIG has been considered a safe medication, with minor and transient adverse effects. With the wider use of IVIG, the reported rate of adverse effects has been increased, some of them are potentially fatal cardiovascular reactions due to induction of hypercoagulable state. We report a 40-year-old female treated with IVIG for Guillain-Barre syndrome, who developed chest pain 1 hr following IVIG infusion. The symptoms were associated with ST elevation in anterior leads on electrocardiogram. This anterior wall myocardial infarction (MI) is compatible with IVIG-induced hypercoagulability and considered as a probable adverse effect of this medication. To the best of our knowledge, this is probably the first case report where a young patient developed acute MI without any cardiac risk factors after IVIG infusion.