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Hypoglycaemic syncope in children secondary to beta-blockers

T Hussain1, K Greenhalgh, K A McLeod

  • 1Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, UK. tarique@doctors.org.uk

Archives of Disease in Childhood
|November 26, 2009
PubMed

Insights

Young children on beta-blockers may experience severe hypoglycemia when fasting, a risk not widely recognized. This can be mistaken for arrhythmia, leading to unnecessary medical interventions.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology

Background:

  • Beta-blockers are commonly prescribed for pediatric arrhythmia prevention.
  • Hypoglycemia is a potential risk in children on beta-blockers, particularly during fasting.
  • Current pediatric drug formularies may not adequately list hypoglycemia as a beta-blocker side effect.

Observation:

  • Five cases of severe hypoglycemia in children treated with beta-blockers for arrhythmia are presented.
  • These episodes occurred in the context of fasting.
  • The number of affected patients represents a notable proportion of the pediatric beta-blocker population at the institution.

Findings:

  • Severe hypoglycemic episodes in children taking beta-blockers can mimic cardiac arrhythmic events.
  • This misinterpretation can lead to inappropriate medical management.
  • Potential consequences include escalation of therapy or unnecessary device implantation.

Implications:

  • Healthcare providers should consider hypoglycemia in fasting children on beta-blockers presenting with concerning symptoms.
  • Clinical vigilance is crucial to differentiate hypoglycemia from arrhythmia.
  • Accurate diagnosis can prevent overtreatment and iatrogenic harm in pediatric patients.

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