Successful pharmacotherapy for asthma exacerbation in an asthmatic patient with long QT syndrome.
- Author:
Hyun Kuk KIM
1
;
Dong Keun CHO
;
Woo Jun LEE
;
Dae Seong MYUNG
;
Eui Ryoung HAN
;
Inseon S CHOI
;
Youngil I KOH
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. yikoh@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Asthma;
Long QT syndrome;
Adrenergic beta-agonists;
Adrenergic beta-antagonists
- MeSH:
Adrenergic beta-Agonists;
Adrenergic beta-Antagonists;
Adult;
Albuterol;
Asthma;
Atenolol;
Bronchial Spasm;
Emergencies;
Female;
Heart Diseases;
Humans;
Long QT Syndrome;
Salmeterol Xinafoate
- From:Korean Journal of Medicine
2009;77(Suppl 1):S249-S253
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
beta -Blockers can cause bronchospasm in asthma. beta 2-agonists prolong the QT interval and alter the clinical course of long QT syndrome (LQTS). We report a case of asthma exacerbation treated cautiously with beta 2-agonists in a patient with LQTS, while LQTS was controlled with low-dose beta 1-antagonists. A 31-year-old woman with LQTS visited the emergency room for asthma exacerbation. FEV1 was 0.5 L (18%) and QTc interval was 520 ms. Low doses of salbutamol or salmeterol were used and gradually increased, while monitoring the QT interval. Simultaneously, a low dose of atenolol was maintained. FEV1 was increased to 2.2 L (83%) without further QT prolongation or cardiac events. The case suggests that lower doses of beta 1-antagonists can be tried for cardiac diseases, even in the presence of asthma exacerbations. beta 2-Agonists may be initiated at lower doses and, if tolerated, the dose can be increased in asthmatic patients with a risk for QT prolongation.
