Angina pectoris induced by sublingual nifedipine

This report describes the case of a 44-year-old man with angina pectoris caused by sublingual nifedipine. He developed chest pain after receiving 5mg sublingual nifedipine for treatment of hypertensive encephalopathy, and his electrocardiogram showed marked depression of the ST segment in the chest leads. Thc coronary angiogram did not show critical stenosis, but revealed a 50% stenotic lesion in the left anterior descending coronary artery. The sudden marked decrease in blood pressure induced may have caused an angina attack. The use of sublingual nifedipine for hypertensive emergency should be abandoned in any case.