Methemoglobinemia after Sodium Nitroprusside Therapy

SODIUM nitroprusside has recently been employed in nonhypertensive patients with acute myocardial infarctions in an effort to reduce the size of infarctio.1 2 3 We recently treated a patient for acute myocardial infarction in whom perioral cyanosis, unrelated to hypoxia, developed while he was receiving sodium nitroprusside. He was found to have a methemoglobin level of 16 per cent (2 g per 100 ml), which we believe represents an adverse reaction to nitroprusside therapy. Case Report A 53-year-old man (with a weight of 78 kg) of Italian extraction was admitted to the hospital with an extensive anterior-wall myocardial infarction. Peak enzyme levels . . .