Mitochondrial Disorder Aggravated by Metoprolol

Area of Science:

• Cardiology
• Neurology
• Pediatrics

Background:

• Beta-adrenergic blocking agents (beta-blockers) are widely used for cardiac arrhythmias and hypertension.
• Adverse effects include fatigue, cramping, dizziness, and dyspnea, which may be amplified in mitochondrial disease.
• Limited data exists on pediatric patients with mitochondrial disorders experiencing beta-blocker adverse effects.

Purpose of the Study:

• To report a case of respiratory distress in a pediatric patient with mitochondrial disorder potentially induced by metoprolol.
• To highlight the potential for aggravated mitochondrial dysfunction and chest wall weakness due to beta-blocker therapy in children.

Main Methods:

• A case report of a pediatric patient with a diagnosed mitochondrial disorder is presented.
• The patient developed respiratory distress after initiation of metoprolol for hypertension.
• Symptoms were evaluated, and metoprolol was discontinued; alternative etiologies were excluded.

Main Results:

• The pediatric patient experienced significant respiratory distress after starting metoprolol.
• Discontinuation of metoprolol led to improvement in respiratory symptoms.
• No other cause for the respiratory distress was identified.

Conclusions:

• Metoprolol may exacerbate mitochondrial dysfunction, leading to increased chest wall weakness and respiratory distress in pediatric patients.
• This case underscores the importance of cautious beta-blocker use in children with mitochondrial disorders.
• Further investigation into the impact of beta-blockers on pediatric mitochondrial myopathies is warranted.