Severe symptomatic sinus bradycardia associated with mesalamine use.
A 29-yr-old white woman was hospitalized with bloody diarrhea secondary to ulcerative colitis. Within 24 h of receiving intravenous steroids, loperamide, and mesalamine, she developed symptomatic hypotension, severe sinus bradycardia, sinus pauses, and junctional escape beats. The hypotension and sinus bradycardia resolved after discontinuing mesalamine. She had a family history of conduction tissue disease but her exercise ECG and Holter studies were normal. She was rehospitalized 6 wk later with an exacerbation of ulcerative colitis and, within 8 h of receiving mesalamine, developed hypotension and severe sinus bradycardia, which resolved after stopping mesalamine. Thus mesalamine should be used with caution, especially in patients predisposed to cardiac conduction tissue disease.
Asirvatham
S
S
Department of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
Sebastian
C
C
Thadani
U
U
D000328:Adult; D001919:Bradycardia / Q000139:chemically induced*; D003093:Colitis, Ulcerative / Q000188:drug therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019804:Mesalamine / Q000009:adverse effects*
D019804:Mesalamine