Nifedipine is widely used in the treatment of hypertension and angina pectoris.1,2 Multiple adverse effects have been described, such as head-ache, peripheral edema, flushing, dizziness, and myocardial ischemia.3 Some adverse effects are induced by an abrupt decrease in arterial pressure.
We describe a patient with malignant hypertension who developed ventricular fibrillation after treatment with sublingual short-acting nifedipine. To our knowledge, this adverse effect of nifedipine has not been published previously.
A 34-year-old woman was admitted with a 4-week history of occipital headache, nose bleeding, vomiting, and visual disturbances, without angina pectoris. She had a history of atrioventricular nodal re-entry tachycardia but not hypertension. She used levonorgestrel ethinyl estradiol, 30 μg/d, and acetaminophen, 500 mg, 4 times a day. On examination, her blood pressure was 200/140 mm Hg in both arms and her pulse rate was regular at 85 bpm. The results of further physical examination and laboratory investigations
Peters FPJ, Zwaan CD, Kho L. Prolonged QT Interval and Ventricular Fibrillation After Treatment With Sublingual Nifedipine for Malignant Hypertension. Arch Intern Med. 1997;157(22):2665-2666. doi:10.1001/archinte.1997.00440430147025