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Propranolol-exacerbated mesenteric ischemia in a patient with hyperthyroidism.
Aydin Seref Köksal1, Oguz Usküdar, Seyfettin Köklü
1Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
The Annals of Pharmacotherapy
|February 11, 2005
Summary
Oral propranolol, a beta-blocker, may rarely cause acute mesenteric ischemia. This case highlights a potential serious adverse reaction to propranolol therapy, emphasizing the need for physician awareness.
Area of Science:
- Cardiology
- Gastroenterology
- Pharmacology
Background:
- Hyperthyroidism is a condition requiring medication management.
- Beta-blockers like propranolol are commonly prescribed for various cardiovascular and non-cardiovascular conditions.
- Mesenteric ischemia is a critical condition affecting blood supply to the intestines.
Observation:
- A patient with hyperthyroidism developed acute abdominal pain and bloody diarrhea shortly after starting oral propranolol.
- Angiography confirmed superior mesenteric artery occlusion.
- Surgical revascularization was successfully performed.
Findings:
- Propranolol use was identified as a possible cause of acute mesenteric ischemia.
- The mechanism may involve decreased cardiac output and altered splanchnic blood flow.
- This represents a rare but serious adverse drug reaction.
Implications:
- Physicians should consider propranolol as a potential cause of mesenteric ischemia in patients presenting with acute abdomen.
- Awareness of this rare adverse effect is crucial for timely diagnosis and management.
- This case underscores the importance of a thorough medication review in patients with gastrointestinal emergencies.