Case ReportsSildenafil-Associated Coronary Thrombosis in a Patient with Angiographically Normal Coronary Arteries: A Case Report with Review of LiteratureSaha, Sandeep A.1 *; O'Cochlain, Brendan2; Singh, Amardeep3; Khosla, Sandeep2Author Information 1Department of Medicine 2Section of Cardiology, Department of Medicine, Rosalind Franklin University of Medicine and Science, Mount Sinai Hospital Medical Center 3Department of Emergency Medicine, Mount Sinai Hospital Medical Center, Chicago, IL *Address for correspondence: Section of Cardiology, Mount Sinai Hospital Medical Center, 1500 South California Avenue, Chicago, IL 60608. E-mail: firstname.lastname@example.org American Journal of Therapeutics: July-August 2006 - Volume 13 - Issue 4 - p 378-384 Buy Abstract Sildenafil is widely used as a primary pharmacological treatment of erectile dysfunction in men with and without underlying cardiovascular disease. Although initial reports of adverse cardiac events were reported soon after Food and Drug Administration approval of this agent, a large body of data suggests that sildenafil does not significantly increase the risk of nonfatal myocardial infarction, stroke, or cardiovascular deaths in patients with preexisting ischemic heart disease. We report the case of a 66-year-old man who developed thrombotic occlusion of the left anterior descending artery and presented with acute myocardial infarction after the use of sildenafil. The patient had presented with chest pain syndrome and borderline elevation of serum troponin I levels 1 week before sildenafil use, and a coronary angiogram had demonstrated normal coronary arteries. This case emphasizes the potential of precipitating coronary thrombosis in patients with unstable plaque after sildenafil use, even in patients with angiographically normal coronary arteries. © 2006 Lippincott Williams & Wilkins, Inc.