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Cardiomyopathy induced by phenylpropanolamine

C Chin¹, M Choy

¹Division of Pediatric Cardiology, University of California Davis Medical Center, Sacramento 95817.

The Journal of Pediatrics

|November 1, 1993

Summary

A minimal overdose of phenylpropanolamine caused acute cardiomyopathy in a 14-year-old girl. The condition, marked by heart dysfunction and arrhythmia, resolved within days.

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Area of Science:

Cardiology
Toxicology
Pediatric Medicine

Background:

Phenylpropanolamine (PPA) is a sympathomimetic agent historically used in decongestants and appetite suppressants.
Adverse cardiovascular events have been rarely associated with PPA, particularly in overdose scenarios.
Understanding the cardiotoxic effects of PPA is crucial for clinical management, especially in younger populations.

Observation:

A 14-year-old female presented with symptoms suggestive of acute cardiac distress following a minor PPA overdose.
Clinical examination revealed myocardial dysfunction and ventricular dysrhythmia.
The patient also exhibited secondary pulmonary edema, notably without systemic hypertension.

Findings:

The acute cardiomyopathy was directly linked to phenylpropanolamine exposure.
Despite the severity of cardiac manifestations (dysfunction, dysrhythmia, pulmonary edema), the absence of hypertension was a notable feature.
The cardiac condition demonstrated a favorable prognosis, with complete resolution over several days.

Implications:

This case highlights the potential cardiotoxicity of phenylpropanolamine, even at low doses, in adolescents.
It underscores the importance of considering PPA as a potential cause of acute cardiomyopathy in pediatric patients presenting with relevant symptoms.
Prompt recognition and supportive care can lead to complete recovery from PPA-induced cardiomyopathy.

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