Reactions 525 - 29 Oct 1994

SVasopressin

Hyponatraemia and bradycardia: case reportSevere hyponatraemia and bradycardia occurred in a

35-year-old woman 3 days after she started treatment with IVvasopressin 0.4 units/min for a gastric variceal haemorrhage.

The patient was lethargic, disoriented and bradycardic. Herheart rate was 50 beats/min and her serum sodium level was116 mmol/L.

Vasopressin therapy was discontinued and the patientbegan to have spontaneous diuresis. Within 1 hour her heartrate normalised to approximately 80 beats/min. Her serumsodium levels were 129 and 139 mmol/L, 8 and 24 hours,respectively, after vasopressin was discontinued.

Author comment: ‘We postulated that the intense pressoraction of vasopressin may have led to myocardial ischaemia andreflex bradycardia while the antidiuretic action of vasopressincaused severe water intoxication in this noncirrhotic patientwith normal renal function.’Munoz J, et al. Severe hyponatremia and bradycardia associated with intravenousvasopressin therapy for variceal hemorrhage. American Journal ofGastroenterology 89: 1742, Sep 1994 [Summarised from an abstract] -USA 800303847

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Reactions 29 Oct 1994 No. 5250114-9954/10/0525-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved