Triptan use preceding life-threatening arrhythmias in charcot-marie-tooth: a case report and review of the literature.
Charcot-Marie-Tooth (CMT) identifies a rare group of inherited disorders of the peripheral nervous system that share clinical features of sensory and motor defects, but rarely affect cardiac function. The few references that relate CMT to cardiac pathology of any sort are so rare that their finding was considered either fortuitous or suggestive of an erroneous diagnosis. The 5-HT1B/1D agonists or triptan drug class was introduced to the clinical practice arena in the early 1990s, and since then several cardiac adverse events have been associated with its use. The authors report the case of a 41-year-old white woman with CMT who had been recently prescribed sumatriptan and who presented with sudden loss of consciousness associated with ventricular fibrillation. These findings have been reported in the literature, but the association of triptan-induced arrhythmias and degenerative neuropathies remains to be established. The authors propose, through this case report and review, that the relative rarity of CMT coupled with the lack of further investigation of their association with conduction abnormalities might have set the stage for underestimation of the potentially synergistic effect with triptans in their capacity to generate life-threatening arrhythmias.
Rubinstein
Jack
J
Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA. rubinsteinj@einstein.edu
Moghe
Rohit
R
Mizrachi
Alberto
A
Dissin
Jonathan
J
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology; D002607:Charcot-Marie-Tooth Disease / Q000150:complications*; D005260:Female; D006801:Humans; D012196:Review Literature as Topic; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D018170:Sumatriptan / Q000627:therapeutic use*
D017366:Serotonin Receptor Agonists; D018170:Sumatriptan