Multiple administration of medication and circulatory failure for malignant ventricular arrhythmias and impairment of liver function


Authors: J. Vítovec;  K. Židová
Authors‘ workplace: I. interní kardioangiologická klinika LF MU a FN u sv. Anny, Brno
Published in: Kardiol Rev Int Med 2012, 14(2): 126-128
Category: Case Report

Overview

Multiple administration of medication and circulatory failure for malignant ventricular arrhythmias and impairment of liver function. This article presents a case history of a polymorbid patient with serious arrhythmias in the ischemic substrate of the myocardium and circulatory failure. The patient was diagnosed with ventricular tachycardias, which led to repeated discharges of the implanted ICD. The patient was receiving multiple medicaments concurrently (17 medicaments), a number of which (doxycykline, amiodarone, atorvastatin) had hepatotoxic characteristics. The increase in liver enzymes can be explained through the simultaneous administration of amiodarone, doxycycline and statine. Nor can the effect of ischemia during circulatory failure in the case of long-term tachyarrhythmias be omitted. The normalisation of liver function occurs following the curbing of serious circulatory arrhythmias and the significant reduction of pharmacotherapies.

Keywords:
malignant arrhythmias – liver impairment – administration of multiple medicaments


Sources

1. Simon JB, Manley PN, Brien JF et al. Amiodarone hepatotoxicity simulating alcoholic liver disease. N Engl J Med 1984; 311: 167–172.

2. Wilson JS, Podrid PJ. Side effects from amiodarone. Am Heart J 1991; 121: 158–171.

3. Ambrosy AP, Vaduganathan M, Huffman MD et al. EVEREST trial investigators. Clinical course and predictive value of liver function tests in patients hospitalized for worsening heart failure with reduced ejection fraction: an analysis of the EVEREST trial. Eur J Heart Fail 2012; 14: 302–311.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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