Phentermine and Coronary Vasospasm-Induced Myocardial Infarction

Mayo Clin Proc. 2019 Jul;94(7):1374-1377. doi: 10.1016/j.mayocp.2018.08.029.


Women presenting to the cardiac catheterization laboratory with normal coronary arteries without significant atherosclerotic disease is a common presentation. In such patients, it is important to maintain a wide differential and consider alternate diagnoses. We present two cases of women presenting with chest pain found to have severe coronary vasospasm in the setting of recent initiation of phentermine. Phentermine may have vasospastic proprieties which are important to consider when prescribing to patients.

Publication types

  • Case Reports

MeSH terms

  • Central Nervous System Stimulants / administration & dosage
  • Central Nervous System Stimulants / adverse effects*
  • Chest Pain / etiology
  • Coronary Vasospasm / chemically induced*
  • Coronary Vasospasm / diagnosis
  • Coronary Vasospasm / drug therapy
  • Electrocardiography
  • Female
  • Humans
  • Middle Aged
  • Myocardial Infarction / chemically induced*
  • Nitroglycerin / therapeutic use
  • Phentermine / administration & dosage
  • Phentermine / adverse effects*
  • Vasodilator Agents / therapeutic use


  • Central Nervous System Stimulants
  • Vasodilator Agents
  • Phentermine
  • Nitroglycerin