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choc, hypotension sévère, cardiomyopathie obstructive, IDM de siège inf avec extension du VD à la phase aigue, hypertension intracranienne, inhibiteurs de la phosphodiestérase de type V (sildénafil) > risque hypotension, aggravation ischémique myocardique et accident coronarien aigu donc délai de 24h min
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