Management of Complicated Facial Hemangiomas with Beta-Blocker (Propranolol) Therapy

Mishra, Anuj; Holmes, William John; Gorst, Catherine; Liew, Se Hwang

doi:10.1097/prs.0b013e31820a656a

Cited by 5 publications

(3 citation statements)

References 1 publication

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“…No patient had cardiac contraindication, and incidence of contraindication, including arrhythmia, myocarditis, significant aortic stenosis, or aortic coarctation, is likely to be low in the general population. [1,[9][10][11][12] affect left ventricle size. However, no data regarding this relationship was presently found.…”

Section: Discussionmentioning

confidence: 99%

Cardiac evaluation in children with hemangiomas

Erdoğan

Sarıalıoğlu

2016

Arch Turk Soc Cardiol

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Section: Discussionmentioning

confidence: 99%

Cardiac evaluation in children with hemangiomas

Erdoğan

Sarıalıoğlu

2016

Arch Turk Soc Cardiol

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“…In many cases the location, size, or associated morbidity of the hemangioma necessitates systemic medical treatment . Since 2008, after the serendipitous observation that oral propranolol can be used to effectively treat hemangiomas , there have been numerous reports supporting this initial finding and propranolol has rapidly become the preferred therapy for IHs requiring medical treatment .…”

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confidence: 99%

Cardiac Screening in Infants with Infantile Hemangiomas before Propranolol Treatment

Blei

McElhinney

Guarini

et al. 2014

Pediatric Dermatology

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There is no uniform pretreatment cardiac evaluation for infants treated with oral propranolol, which is now the drug of choice for hemangiomas of infancy requiring systemic medical intervention. The aim of this study was to report and evaluate the findings of pretreatment cardiac evaluation. Data were reviewed for patients evaluated by a single hemangioma specialist and a single pediatric cardiologist prior to initiation of propranolol for infantile hemangioma. Cardiac evaluation included a complete echocardiogram. From July 2009 through January 2013, 239 consecutive patients 12 months of age or younger (median 2.7 months) were screened. No patients had cardiac contraindications to propranolol. However, 50 patients (21%) had an abnormal echocardiogram: 39 atrial septal defects (5 associated with right heart enlargement), 6 ventricular septal defects, 2 patent ductus arteriosus, 1 aortic coarctation, 1 pulmonary valve stenosis, and 1 aberrant subclavian artery. Overall, 69 patients had an audible heart murmur, 44 of which were not associated with pathologic findings on echocardiogram. All patients with a ventricular septal defect and 16 of 39 with an atrial septal defect had a murmur. Two of seven patients with PHACE syndrome had cardiac anomalies. None of the findings precluded the use of propranolol. Assisted reproductive technologies were used in 18% of pregnancies, including in vitro fertilization in 12%. Cardiac contraindications to propranolol treatment are uncommon in patients with infantile hemangioma. However, anatomic abnormalities were more common than reported in the general population. Further study is necessary to determine whether there is a pathogenic relationship between cardiac defects and nonsyndromic infantile hemangioma.

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“…Agents with reported activity in treating IHs include corticosteroids, interferon‐α, vinca alkaloids, and recently β‐blockers. Since the initial report of oral propranolol use for the treatment of IHs in 2008, there has been a flurry of case series describing topical and oral β‐blocker efficacy . Given propranolol's efficacy and immediate availability in an oral solution, it has rapidly been adopted as a first‐line therapy for IHs.…”

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confidence: 99%

Adverse Events in Young and Preterm Infants Receiving Topical Timolol for Infantile Hemangioma

Frommelt

Juern

Siegel

et al. 2016

Pediatric Dermatology

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In this cohort of at-risk infants, topical timolol appeared to provide safe treatment for IHs in full-term infants receiving a dose of less than 0.2 mg/kg/day, but infants with a PMA of less than 44 weeks and weight at treatment initiation of less than 2,500 g may be at risk of adverse events, including bradycardia, hypotension, apnea, and hypothermia. We recommend close monitoring of temperature, blood pressure, and heart rate in premature and low-birthweight infants with IHs at initiation of and during therapy with topical timolol.

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Management of Complicated Facial Hemangiomas with Beta-Blocker (Propranolol) Therapy

Cited by 5 publications

References 1 publication

Cardiac evaluation in children with hemangiomas

Cardiac evaluation in children with hemangiomas

Cardiac Screening in Infants with Infantile Hemangiomas before Propranolol Treatment

Adverse Events in Young and Preterm Infants Receiving Topical Timolol for Infantile Hemangioma

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