Sotalol-induced coronary spasm in a patient with dilated cardiomyopathy associated with sustained ventricular tachycardia.
A 54-year-old man with severe left ventricular dysfunction due to dilated cardiomyopathy was referred to our hospital for symptomatic incessant sustained ventricular tachycardia (VT). After the administration of nifekalant hydrochloride, sustained VT was terminated. An alternate class III agent, sotalol, was also effective for the prevention of VT. However, one month after switching over nifekalant to sotalol, a short duration of ST elevation was documented in ECG monitoring at almost the same time for three consecutive days. ST elevation with chest discomfort disappeared since he began taking long-acting diltiazem. Coronary vasospasm may be induced by the non-selective beta-blocking properties of sotalol.
Muto
Shigenori
S
Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki.
Ashizawa
Naoto
N
Arakawa
Syuji
S
Tanaka
Kyoei
K
Komiya
Norihiro
N
Toda
Genji
G
Seto
Shinji
S
Yano
Katsusuke
K
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D013015:Sotalol / Q000009:adverse effects*; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D013015:Sotalol