| Successful pharmacotherapy for asthma exacerbation in an asthmatic patient with long QT syndrome |
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Hyun Kuk Kim, Dong Keun Cho, Woo Jun Lee, Dae Seong Myung, Eui Ryoung Han, Inseon S. Choi, Youngil I. Koh |
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| QT 연장 증후군을 동반한 천식 악화의 성공적 약물치료 1예 |
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김현국, 조동근, 이우진, 명대성, 한의령, 최인선, 고영일 |
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| Abstract |
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β-Blockers can cause bronchospasm in asthma. β2-agonists prolong the QT interval and alter the clinical course of long QT syndrome (LQTS). We report a case of asthma exacerbation treated cautiously with β2-agonists in a patient with LQTS, while LQTS was controlled with low-dose β1-antagonists. A 31-year-old woman with LQTS visited the emergency room for asthma exacerbation. FEV1 was 0.5 L (18%) and QTc interval was 520 ms. Low doses of salbutamol or salmeterol were used and gradually increased, while monitoring the QT interval. Simultaneously, a low dose of atenolol was maintained. FEV1 was increased to 2.2 L (83%) without further QT prolongation or cardiac events. The case suggests that lower doses of β1-antagonists can be tried for cardiac diseases, even in the presence of asthma exacerbations. β2-Agonists may be initiated at lower doses and, if tolerated, the dose can be increased in asthmatic patients with a risk for QT prolongation. |
| Key Words:
Asthma; Long QT syndrome; Adrenergic β-agonists; Adrenergic β-antagonists |
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