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Hydrochlorothiazide-induced pulmonary edema with severe acute myocardial dysfunction
J H Frierson1, S L Marvel, G M Thomas
1Department of Medicine, Salem Hospital, Oregon, USA.
Clinical Cardiology
|February 1, 1995
Summary
Hydrochlorothiazide can cause rare adverse drug reactions, including acute pulmonary edema and hypotension. This case report details a novel finding of a prolonged low cardiac output state associated with this reaction.
Area of Science:
- Pharmacology
- Cardiology
- Pulmonology
Background:
- Hydrochlorothiazide is a common diuretic used to treat hypertension and edema.
- Adverse drug reactions to hydrochlorothiazide, though rare, can be severe.
- Previous reports suggest a noncardiogenic pulmonary edema syndrome associated with hydrochlorothiazide.
Observation:
- A 73-year-old woman developed acute pulmonary edema and hypotension within an hour of taking hydrochlorothiazide 50 mg.
- Hemodynamic monitoring revealed a persistent low cardiac output state lasting over 24 hours.
- No other potential causes for the observed symptoms were identified.
Findings:
- This case presents a novel association between hydrochlorothiazide-induced adverse reaction and a refractory low cardiac output state.
- The observed hemodynamic compromise extends beyond previously described noncardiogenic pulmonary edema syndromes.
- This finding challenges the established understanding of hydrochlorothiazide's cardiovascular adverse effects.
Implications:
- Clinicians should consider monitoring cardiac output in patients experiencing severe reactions to hydrochlorothiazide.
- Further research is warranted to elucidate the mechanisms underlying hydrochlorothiazide-induced cardiac dysfunction.
- This case expands the spectrum of known adverse drug reactions associated with hydrochlorothiazide, impacting patient safety and drug management strategies.