Lamaison D, Vacher D, Berenfeld A, Schandrin C, Lavarenne V
Service de Cardiologie, Hôpital St-Jacques, Clermont-Ferrand.
Therapie. 1990 Sep-Oct;45(5):411-3.
Patient 1 received carteolol and captopril for hypertension. Three days after a slow-release diltiazem preparation (300 mg) had been introduced, he developed cardiogenic shock and sinus bradycardia (heart rate: 30/mn) with acidosis and severe hyperkaliemia. He was successfully treated by temporary pacing and dobutamine. Patient 2 had received sotalol and captopril for several years. Twelve hours after slow release diltiazem had been added, he was found in cardiogenic shock and extreme bradycardia with wide QRS, acidosis and hyperkaliemia. He died one hour later despite intensive emergency treatment. Concomitant use of beta-blockers and calcium channel blockers has been reported in patients suffering of severe coronary heart disease. However, several adverse reactions similar to our cases have been described. Slow-release diltiazem should be avoided in hypertensive patients taking beta-blockers.
患者1因高血压接受了卡替洛尔和卡托普利治疗。在引入缓释地尔硫䓬制剂（300毫克）三天后，他出现了心源性休克和窦性心动过缓（心率：30次/分钟），伴有酸中毒和严重高钾血症。他通过临时起搏和多巴酚丁胺成功得到治疗。患者2接受索他洛尔和卡托普利治疗数年。在加用缓释地尔硫䓬12小时后，他被发现处于心源性休克状态，伴有极度心动过缓、宽QRS波、酸中毒和高钾血症。尽管进行了强化急救治疗，他还是在一小时后死亡。在患有严重冠心病的患者中曾有β受体阻滞剂和钙通道阻滞剂联合使用的报道。然而，已经描述了一些与我们病例相似的不良反应。服用β受体阻滞剂的高血压患者应避免使用缓释地尔硫䓬。
