Related Experiment Video

Updated: Aug 15, 2026

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
14:39

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Myocardial ischemia induced by nebulized fenoterol for severe childhood asthma

L Z Zanoni1, D B Palhares, L C T Consolo

  • 1Department of Pediatrics, Hospital Universitario, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil. Izzanoni@terra.com.br

Indian Pediatrics
|November 5, 2005
PubMed

Insights

Continuous fenoterol inhalation in children with severe acute asthma can cause tachycardia and electrocardiogram (EKG) changes indicating myocardial ischemia, even with normal cardiac enzyme levels.

Area of Science:

  • Pediatric Pulmonology
  • Cardiology
  • Clinical Pharmacology

Background:

  • Severe acute asthma is a critical condition in children requiring effective bronchodilator therapy.
  • Fenoterol is a beta-2 adrenergic agonist used for asthma treatment.
  • Potential cardiovascular side effects of bronchodilators, especially in severe cases, warrant investigation.

Purpose of the Study:

  • To investigate the occurrence of myocardial ischemia in children with severe acute asthma treated with continuous inhaled fenoterol.
  • To assess the cardiac safety profile of high-dose inhaled fenoterol in this pediatric population.

Main Methods:

  • A study involving 30 children diagnosed with severe acute asthma.
  • Administration of inhaled fenoterol at a dose of 0.5 mg/kg (maximum 15 mg) over one hour.
  • Monitoring of heart rate, electrocardiograms (EKGs), and cardiac enzymes (creatine kinase, CK-MB, troponin) at specified intervals.

Main Results:

  • All patients experienced a significant increase in heart rate (tachycardia).
  • Six out of thirty patients exhibited EKG changes suggestive of myocardial ischemia.
  • Cardiac enzyme levels remained within normal limits in all patients, despite EKG abnormalities.

Conclusions:

  • Children with severe acute asthma undergoing continuous fenoterol inhalation are at risk for developing tachycardia.
  • Electrocardiogram changes indicative of myocardial ischemia can occur in these patients, independent of elevated cardiac enzyme levels.
  • Continuous inhaled fenoterol may induce subclinical myocardial ischemia in severe pediatric asthma cases.

Related Concept Videos

Asthma III: Clinical Manifestations01:13

Asthma III: Clinical Manifestations

Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
Asthma-II: Pathophysiology and Classification01:26

Asthma-II: Pathophysiology and Classification

Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma-III: Symptoms and Complications01:24

Asthma-III: Symptoms and Complications

Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma: Pathogenesis and Management01:20

Asthma: Pathogenesis and Management

Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma-I: Introduction01:29

Asthma-I: Introduction

Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...