Document Detail

Aortic dissection due to discontinuation of beta-blocker therapy.
MedLine Citation:
PMID:  8261479     Owner:  NLM     Status:  MEDLINE    
beta-Blockers are known to protect a vulnerable aorta from acute dissection, as well as reducing the risk of recurrent dissection. This case presentation reports the history of a 60-year-old male suffering from acute aortic dissection following discontinuation of beta-blocker therapy. The patient has shown arterial hypertension for about 20 years treated solely by beta-blockers. Two days after stopping the use of metoprolol, a nonselective beta 1-blocker without ISA, the patient developed severe chest pain during exercise. Diagnosis of type I-aortic dissection according to DeBakey was achieved by transthoracal echocardiography and computed tomography. Successful surgery by replacement of the ascending aorta was performed about 1 h following admission to the intensive care unit. During the procedure, tamponade of the left ventricle occurred followed by cardiogenic shock. Postoperative management was complicated by prolonged respiratory therapy and acute gastrointestinal bleeding; 1-year follow-up showed no evidence of disease. Thus, in this case acute dissection may be the consequence of discontinuing the use of metoprolol, possibly due to uncontrolled hypertension or specific response to the beta-blocker.
B Eber; K H Tscheliessnigg; M Anelli-Monti; P Kaufmann; A Lueger; P Delgado; P Kullnig
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cardiology     Volume:  83     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  1993  
Date Detail:
Created Date:  1994-01-27     Completed Date:  1994-01-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  128-31     Citation Subset:  IM    
Department of Internal Medicine, Karl Franzens University, Graz, Austria.
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MeSH Terms
Aneurysm, Dissecting / chemically induced*,  surgery
Aortic Aneurysm, Thoracic / chemically induced*,  surgery
Blood Vessel Prosthesis
Hemodynamics / drug effects,  physiology
Hypertension / drug therapy*,  surgery
Metoprolol / adverse effects*,  therapeutic use
Middle Aged
Substance Withdrawal Syndrome / etiology*,  surgery
Tomography, X-Ray Computed
Reg. No./Substance:

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