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      Aortic Dissection due to Discontinuation of Beta-Blocker Therapy

      case-report

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          Abstract

          β-Blockers are known to protect a vulnerable aorta from acute dissection, as well as reducing the risk of recurrent dissection. This case presentation reports the history of a 60-year-old male suffering from acute aortic dissection following discontinuation of β-blocker therapy. The patient has shown arterial hypertension for about 20 years treated solely by β-blockers. Two days after stopping the use of metoprolol, a nonselective β<sub>1</sub>- blocker without ISA, the patient developed severe chest pain during exercise. Diagnosis of type I-aortic dissection according to DeBakey was achieved by transthoracal echocardiography and computed tomography. Successful surgery by replacement of the ascending aorta was performed about 1 h following admission to the intensive care unit. During the procedure, tamponade of the left ventricle occurred followed by cardiogenic shock. Postoperative management was complicated by prolonged respiratory therapy and acute gastrointestinal bleeding; 1-year follow-up showed no evidence of disease. Thus, in this case acute dissection may be the consequence of discontinuing the use of metoprolol, possibly due to uncontrolled hypertension or specific response to the β-blocker.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1993
          1993
          14 November 2008
          : 83
          : 1-2
          : 128-131
          Affiliations
          Departments of aInternal Medicine, bSurgery, and cRadiology, Karl Franzens University, Graz, Austria
          Article
          175959 Cardiology 1993;83:128–131
          10.1159/000175959
          8261479
          f19989a8-3014-4c1b-b3ec-e828d70432fa
          © 1993 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 20 February 1993
          : 09 April 1993
          Page count
          Pages: 4
          Categories
          Case Report

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Arterial hypertension,&beta;-Blocker,Metoprolol,Thoracic surgery,Aortic dissection

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