{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T03:20:25Z","timestamp":1771989625849,"version":"3.50.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Methylergonovine is a vasoconstrictive agent historically used as a provocative agent in the lab for coronary vasospasm; it is also a first line uterotonic agent for management of postpartum hemorrhage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case Presentation<\/jats:title>\n                <jats:p>A 29-year-old female with history of smoking and idiopathic thrombocytopenia received intramuscular methylergonovine after delivery of twins for intrauterine hemorrhage management. Subsequently, she had episodes of chest pain with high sensitivity Troponin I elevation to 1509 ng\/L with accompanying septal T wave inversions, decreased left ventricular ejection fraction to 49% and basal septal wall hypokinesis. Computed tomography (CT) coronary angiogram showed patent coronary arteries and no coronary arterial dissection. The patient was conservatively managed with aspirin and metoprolol, and on follow up had fully recovered left ventricular function with resolution of wall motion abnormalities. Given this, coronary vasospasm due to intramuscular methylergonovine is the most likely cause of patient\u2019s chest pain and associated myocardial ischemia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Intramuscular, intrauterine, intravenous, and even oral methylergonovine can rarely cause coronary vasospasm leading to myocardial ischemia. Cardiologists caring for postpartum patients should be aware of these potential lethal complications; prompt identification and administration of sublingual nitroglycerin can prevent severe complications of arrythmias, heart block, or cardiac arrest.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-023-03216-9","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T21:57:42Z","timestamp":1681768662000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Post-partum myocardial ischemia due to intramuscular methylergonovine-induced coronary vasospasm: case report"],"prefix":"10.1186","volume":"23","author":[{"given":"Sae K","family":"Jang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Berlacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisse","family":"Hauspurg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"3216_CR1","doi-asserted-by":"publisher","unstructured":"Bertrand ME, LaBlanche JM, Tilmant PY, Thieuleux FA, Delforge MR, Carre AG, Asseman P, Berzin B, Libersa C, Laurent JM. Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography. Circulation. 1982 Jun;65(7):1299 \u2013 306. doi: https:\/\/doi.org\/10.1161\/01.cir.65.7.1299. PMID: 7200405.","DOI":"10.1161\/01.cir.65.7.1299"},{"key":"3216_CR2","doi-asserted-by":"publisher","unstructured":"Bory M, Joly P, Bonnet JL, Djiane P, Serradimigni A. Methergin testing with angiographically normal coronary arteries. Am J Cardiol. 1988 Feb 1;61(4):298\u2013302. doi: https:\/\/doi.org\/10.1016\/0002-9149(88)90934-4. PMID: 3341205.","DOI":"10.1016\/0002-9149(88)90934-4"},{"key":"3216_CR3","unstructured":"Frantz RP, Lerman A, Edwards BS, Olson LJ, Higano ST, Schwartz RS, Daly RC, McGregor CG, Rodeheffer RJ. Methylergonovine-induced diffuse coronary spasm in a patient with exercise-induced coronary spasm after heart transplantation. J Heart Lung Transplant. 1994 Sep-Oct;13(5):834\u20139. PMID: 7803424."},{"key":"3216_CR4","doi-asserted-by":"publisher","unstructured":"Lin YH, Seow KM, Hwang JL, Chen HH. Myocardial infarction and mortality caused by methylergonovine. Acta Obstet Gynecol Scand. 2005 Oct;84(10):1022. doi: https:\/\/doi.org\/10.1111\/j.0001-6349.2005.0058d.x. PMID: 16167925.","DOI":"10.1111\/j.0001-6349.2005.0058d.x"},{"key":"3216_CR5","doi-asserted-by":"publisher","unstructured":"Kuczkowski KM. Myocardial ischemia induced by intramyometrial injection of methylergonovine maleate. Anesthesiology. 2004 Apr;100(4):1043. doi: https:\/\/doi.org\/10.1097\/00000542-200404000-00055. PMID: 15087660.","DOI":"10.1097\/00000542-200404000-00055"},{"key":"3216_CR6","doi-asserted-by":"publisher","unstructured":"Tsui BC, Stewart B, Fitzmaurice A, Williams R. Cardiac arrest and myocardial infarction induced by postpartum intravenous ergonovine administration. Anesthesiology. 2001 Feb;94(2):363-4. doi: https:\/\/doi.org\/10.1097\/00000542-200102000-00033. PMID: 11176106","DOI":"10.1097\/00000542-200102000-00033"},{"key":"3216_CR7","doi-asserted-by":"crossref","unstructured":"Taylor GJ, Cohen B. Ergonovine-induced coronary artery spasm and myocardial infarction after normal delivery. Obstet Gynecol. 1985 Dec;66(6):821-2. PMID: 3877894.","DOI":"10.1097\/00132582-198606000-00034"},{"key":"3216_CR8","doi-asserted-by":"publisher","unstructured":"de Labriolle A, Gen\u00e9e O, Heggs LM, Fauchier L. Acute myocardial infarction following oral methyl-ergometrine intake. Cardiovasc Toxicol. 2009 Mar;9(1):46\u20138. https:\/\/doi.org\/10.1007\/s12012-009-9031-9. Epub 2009 Feb 14. PMID: 19219407.","DOI":"10.1007\/s12012-009-9031-9"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-023-03216-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-023-03216-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-023-03216-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T21:58:54Z","timestamp":1681768734000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-023-03216-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,17]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["3216"],"URL":"https:\/\/doi.org\/10.1186\/s12872-023-03216-9","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,17]]},"assertion":[{"value":"15 January 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Signed informed consent was obtained from the patient for publication of this case report\u2019s contents.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"199"}}