Acute myocardial infarction and coronary vasospasm associated with the ingestion of cayenne pepper pills in a 25-year-old male

Abstract

Capsaicin, one of the major active components of cayenne pepper pills, is an over-the-counter substance with sympathomimetic activity used commonly by young individuals for weight loss. Here we report the case of a previously healthy young male who developed severe chest pain after using cayenne pepper pills for slimming and sustained an extensive inferior myocardial infarction. Electrocardiography combined with a bedside transthoracic echocardiogram confirmed the diagnosis of acute myocardial infarction. The patient denied using illicit substances, and he had no risk factors for coronary artery disease. His medication history revealed that he had recently started taking cayenne pepper pills for slimming. A subsequent coronary angiogram revealed patent coronary arteries, suggesting that the mechanism was vasospasm. We postulate that the patient developed acute coronary vasospasm and a myocardial infarction in the presence of this known sympathomimetic agent. This case highlights the potential danger of capsaicin, even when used by otherwise healthy individuals.

Transient Receptor Potential Vanilloid 1 Regulates Mitochondrial Membrane Potential and Myocardial Reperfusion Injury

“…Even a small change in heart rate may be detrimental if a person is having an acute myocardial infarction. Case reports also suggest that excessive consumption of cayenne pepper (the active component of which is capsaicin) can result in myocardial infarction due to coronary vasospasm . Consequently, direct agonists and antagonists of the TRPV1 channel have substantial disadvantages over indirect modulation, as described with V1‐cal.…”

Biochemical Profile and Body Composition Alteration of Amateur Bodybuilders during the Pre-Contest Period

“…However, the cost-benefit of this practice might be addressed critically, since the use of AAS might increase catecholamine release and β-adrenergic receptor expression [12], which might potentiate the harmful effects of stimulants. Indeed, the association of AAS with stimulants has been shown to give rise to an additional risk of MI [11].…”

An unusual cause of thunderclap headache after eating the hottest pepper in the world – “The Carolina Reaper”

“…It can occur without an identifiable cause, as an idiosyncratic reaction to certain medications (ergotamine, selective serotonin reuptake inhibitors, alpha–sympathomimetic decongestants, and triptans), or secondary to an illicit drug (cocaine, amphetamines, and ecstasy) 1. No cases of RCVS secondary to peppers or cayenne have been previously reported, but ingestion of cayenne pepper has been associated with coronary vasospasm and acute myocardial infarction 2. Given the development of symptoms immediately after exposure to a known vasoactive substance, it is plausible that our patient had RCVS secondary to the ‘Carolina Reaper.’ Treatment is observation and removal of the offending agent.…”