Terlipressin-induced ventricular arrhythmia
Ján Urge1, Frantisek Sincl, Vlastimil Procházka
1Department of Internal Medicine II, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc, Czech Republic.
Scandinavian Journal of Gastroenterology
|July 9, 2008
Summary
Terlipressin treatment for gastrointestinal bleeding can cause dangerous heart rhythm problems, including prolonged QT interval and torsade de pointes, especially in patients with risk factors. Discontinuation of terlipressin led to recovery and no recurrence of arrhythmia.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Gastrointestinal (GI) bleeding is a serious condition requiring effective treatment.
- Terlipressin is an effective vasoconstrictor used for managing GI bleeding.
Observation:
- A 50-year-old male patient developed a prolonged QT interval and torsade de pointes during intravenous terlipressin therapy for recurrent GI bleeding.
- The patient had risk factors for acquired long QT syndrome, including mineral imbalance and alcohol-induced hepatic impairment.
Findings:
- Terlipressin administration was associated with the new onset of a prolonged QT interval and torsade de pointes.
- Discontinuation of terlipressin resulted in the normalization of the QTc interval.
- The patient's cardiac rhythm stabilized after a counter-shock, and no further arrhythmias were observed during follow-up.
Implications:
- Clinicians should be aware of the potential cardiac risks associated with terlipressin, particularly in patients with pre-existing risk factors.
- Careful cardiac monitoring is warranted during terlipressin treatment, especially in vulnerable populations.
- This case highlights the importance of considering drug-induced cardiac events in patients presenting with arrhythmias.
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