Document Detail


Profound hypotension in a tetraplegic patient following angiotensin-converting enzyme inhibitor lisinopril. Case report.
MedLine Citation:
PMID:  7708426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present the case of a 60 year old C6 complete tetraplegic patient who developed profound hypotension following initiation of the angiotensin-converting enzyme inhibitor lisinopril to control blood pressure. Other causes of hypotension, such as myocardial infarction and sepsis was ruled out. Inhibition of the renin-angiotensin-aldosterone system was the probable cause of hypotension. This case demonstrates the critical importance of the renin-angiotensin-aldosterone axis in the maintenance of blood pressure in tetraplegic patients, who may lack input from the brain to sympathetic neurons, and therefore have increased reliance on the renin-angiotensin-aldosterone axis for the maintenance of blood pressure. Angiotensin-converting enzyme inhibitors should be avoided in tetraplegic patients, unless other treatment modalities are ineffective.
Authors:
J K Schmitt; K S Koch; M Midha
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Paraplegia     Volume:  32     ISSN:  0031-1758     ISO Abbreviation:  Paraplegia     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-05-09     Completed Date:  1995-05-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985038R     Medline TA:  Paraplegia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  871-4     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, Virginia 23249.
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / adverse effects*
Blood Pressure / drug effects
Humans
Hypotension / chemically induced*,  complications
Lisinopril / adverse effects*
Male
Middle Aged
Obesity / complications
Quadriplegia / complications*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 83915-83-7/Lisinopril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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