UNSTABLE ANGINA ASSOCIATED WITH SERTRALINE

An 81-year-old woman reported with chest pain occurring shortly after initiating treatment with sertraline. She had no prior history of card iovascular disease. She developed nausea and malaise 4 h after her fir st dose, which resulted in avoidance of further treatment. After volun tarily reinitiating sertraline 10 days later, she again developed naus ea and malaise but persisted with treatment. On the second day, her ga strointestinal symptoms were accompanied by crushing retrosternal ches t pain radiating to both arms and resolving spontaneously after 10 min s. Following the third dose of sertraline, the patient experienced sev ere and persistent crushing retrosternal chest pain radiating to both arms. She was hospitalized with a diagnosis of unstable angina and tre ated with acetylsalicylic acid, intravenous heparin and nitroglycerin. The temporal relationship of chest pain onset following ingestion of sertraline is strongly suggestive of an adverse medication effect.