Visual hallucinations and illusions with propranolol.

and chest pain simulating prolonged angina or a myocardial infarction which occurred about 30 minutes after taking the drug. These symptoms lasted for up to three hours and did not recur when the drug was withdrawn. We considered the chest pain to be a direct effect of nifedipine treatment. Nifedipine increases the myocardial blood supply and reduces coronary sinus lactate concentrations. It also tends to increase cardiac output and heart rate and to reduce peripheral resistance.4 5 These effects possibly caused the cardiac pain in our patients. We suggest that patients starting treatment with nifedipine should be warned to discontinue the drug immediately if they experience these side effects.