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Hi folks,
Read that 5% of patients exposed to Amiodarone (long term or high dose) will develop 1 of the 4 forms of lung toxicity. Not to mention all the other side effects of this medication (thryoid, skin, etc)...
I've been thinking long and hard about this one and would like to get some general opinions.
This is a learning case, not a real scenario and therefore the question and subsequent opinions are only for learning purpose and not actual practice.
Say, y'all have a patient that comes to see you, who has rheumatic valvular disease with mitral and aortic valve prosthesis 15 years ago. This patient has chronic a-fib that was failed sotalol and propafenone but responded to atenelol over the last 15 years. Say the patient then developed symptomatic bradycardia due to sick sinus syndrome and had a pacer placed. Say then during the bout of patients symptomatic bradycardia, their atrial fib bumped back into action, what medication would y'all use to control the a-fib. Let's make it juicy and say the patient is your family member so you're quite hesitant/cautious about amiodarone. Would you retry Sotalol or Propafenone?
What do you think? Would love to learn off you Cardiologists out there 🙂
Thanks,
A
Read that 5% of patients exposed to Amiodarone (long term or high dose) will develop 1 of the 4 forms of lung toxicity. Not to mention all the other side effects of this medication (thryoid, skin, etc)...
I've been thinking long and hard about this one and would like to get some general opinions.
This is a learning case, not a real scenario and therefore the question and subsequent opinions are only for learning purpose and not actual practice.
Say, y'all have a patient that comes to see you, who has rheumatic valvular disease with mitral and aortic valve prosthesis 15 years ago. This patient has chronic a-fib that was failed sotalol and propafenone but responded to atenelol over the last 15 years. Say the patient then developed symptomatic bradycardia due to sick sinus syndrome and had a pacer placed. Say then during the bout of patients symptomatic bradycardia, their atrial fib bumped back into action, what medication would y'all use to control the a-fib. Let's make it juicy and say the patient is your family member so you're quite hesitant/cautious about amiodarone. Would you retry Sotalol or Propafenone?
What do you think? Would love to learn off you Cardiologists out there 🙂
Thanks,
A
