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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
Summary
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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