title: [Malignant hypertension and cardiac decompensation after overuse of nasal decongestant: A case report and literature review].
abstract: BACKGROUND
  Vasoconstrictors, widely prescribed in the congestive states during acute rhinitis, are responsible for many cases of drug-related iatrogenic disease.
  
  
  METHODS
  We report the case of a 40-year-old man, who presented with an episode of malignant hypertensive crisis associated with life-threatening congestive heart decompensation. The patient interview revealed consumption to supra-therapeutic dosage of an association of naphazoline and prednisolone nasal sprays. The diagnostic work-up allowed to rule out disease-related causes of secondary hypertension. The drug-related disease was thus retained.
  
  
  CONCLUSIONS
  The results of the literature review showed many cases of vasoconstrictor poisoning responsible for central nervous system and cardiovascular involvement, especially in young children. This first case of heart failure related to nasal decongestant administration increases the scope of potentially serious risks of these drugs and demonstrates the outreach needs for health professionals and patients about their proper use.
authors.affiliation: Pharmacie, hôpital Nord-Ouest, BP 436, 69655 Villefranche-sur-Saône, France. Electronic address: teddy.novais@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Novais
authors.affiliation: Pharmacie, hôpital Nord-Ouest, BP 436, 69655 Villefranche-sur-Saône, France.
authors.forename: M
authors.initials: M
authors.lastname: Bourdelin
authors.affiliation: Service de cardiologie, hôpital Nord-Ouest, BP 436, 69655 Villefranche-sur-Saône, France.
authors.forename: O
authors.initials: O
authors.lastname: Le Vavasseur
authors.affiliation: Pharmacie, hôpital Nord-Ouest, BP 436, 69655 Villefranche-sur-Saône, France.
authors.forename: H
authors.initials: H
authors.lastname: Bontemps
mesh_terms: D000328:Adult; D006333:Heart Failure / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D006801:Humans; D006974:Hypertension, Malignant / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D008297:Male; D009278:Naphazoline / Q000009:adverse effects; D014663:Nasal Decongestants / Q000009:adverse effects*; D011239:Prednisolone / Q000009:adverse effects; D000067490:Prescription Drug Overuse / Q000009:adverse effects*
chemical_list: D014663:Nasal Decongestants; D011239:Prednisolone; D009278:Naphazoline
keywords: Heart failure; Hypertension; Hypertension artérielle; Insuffisance cardiaque; Naphazoline; Nasal sprays; Pulvérisations nasales; Toxicity; Toxicité