Minoxidil poisoning presenting as acute coronary syndrome: a rare case scenario

Panchal, Saminder; Mudgalkar, Nikhil; Reddy, K. Ravinder

doi:10.5455/2320-6012.ijrms20140583

Cited by 1 publication

(2 citation statements)

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“…Subendocardial ischemia is believed to be caused by an increased myocardial oxygen demanddue to secondary catecholamine overload that increases myocardial contractilityand decreasedcoronary perfusion that is due to tachycardia and hypotension acute minoxidil intoxication. Similar transitory ECG changes when larger doses of minoxidil (about 3 grams) had been given were described by other authors [8,9]. Some authors have presented development of nontransmural infarction as a result of ingestion of similar amount of minoxidil solution, associated with pleural effusion and good response to conservative treatment [7].…”

Section: Discussionsupporting

confidence: 71%

“…In our patient the cause for kidney failure was dishemodynamicand was probably a result of delayed hospitalization (12 hours post-ingestion) and prolonged kidney hypoperfusion. In other case reports a smaller degree of oliguria was registered as well as a smaller increase in degradation products with more rapid response to drug treatment as a result of the urgent hospitalization (two hours post-ingestion at the most) [5,7,9]. There is a lack of literature on minoxidil direct nephrotoxicity that results in decreased kidney function in a state of acute overdosage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Minoxidil Overdosage: A Case Report

Petkovska¹,

Petronijevic²,

Chibishev³

et al. 2016

Macedonian Medical Review

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A 64-year-old man ingested about 60 ml 2% of topical minoxidil solution in order tomake his hair grow faster. Twelve hours after ingestion he was brought to the University Clinic of Toxicology with severe hypotension, tachycardia, chest pain and subendocardial ischemia. ECG showed diffuse T-wave inversion and depressed ST segments. He was also oligoanuric at admission. In spite of the intensive hydration with crystalloidsolutions and intravenous dopamine administration that resulted in partial hemodynamic improvement and resolution of the ECG changes, kidneyfailure occurred. After two hymodialysis sessions, urea and creatinine levels returned to normal and rebound hypertension appeared. The patient was discharged after 12 days of hospitalization in a good condition. Topical minoxidilsolution is formulation used for treatment of androgenic alopecia. If orally ingested it leads to severe hypotension, acute coronary syndrome, compensatory tachycardia and acute kidneyfailure. Emergency therapeutic approach is a precondition for successful outcome.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%