Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine
Reversible acetylcholinesterase inhibitors are used as first-line treatment for myasthenia gravis. They improve symptoms by increasing concentration of acetylcholine at the neuromuscular junction and stimulating nicotinic receptors. Serious bradyarrhythmias can occur from muscarinic stimulation in h...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2017/6956298 |
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| _version_ | 1832554462533648384 |
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| author | Mohammad Saud Khan Abhinav Tiwari Zubair Khan Himani Sharma Mohammad Taleb Jeffrey Hammersley |
| author_facet | Mohammad Saud Khan Abhinav Tiwari Zubair Khan Himani Sharma Mohammad Taleb Jeffrey Hammersley |
| author_sort | Mohammad Saud Khan |
| collection | DOAJ |
| description | Reversible acetylcholinesterase inhibitors are used as first-line treatment for myasthenia gravis. They improve symptoms by increasing concentration of acetylcholine at the neuromuscular junction and stimulating nicotinic receptors. Serious bradyarrhythmias can occur from muscarinic stimulation in heart, which in rare cases may progress to asystole. These patients can initially be managed with hyoscyamine, a muscarinic antagonist. Persistence of bradyarrhythmias even after hyoscyamine treatment may warrant pacemaker placement. We present a case of 65-year-old female patient who presented with diplopia, dysphagia, and muscle weakness who was diagnosed with myasthenia gravis. She developed significant sinoatrial node block with prolonged asystole after starting treatment with pyridostigmine which was successfully treated with hyoscyamine, thus avoiding pacemaker placement. |
| format | Article |
| id | doaj-art-dd897c23a64a445db2ec608aecce5511 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-dd897c23a64a445db2ec608aecce55112025-02-03T05:51:36ZengWileyCase Reports in Cardiology2090-64042090-64122017-01-01201710.1155/2017/69562986956298Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with HyoscyamineMohammad Saud Khan0Abhinav Tiwari1Zubair Khan2Himani Sharma3Mohammad Taleb4Jeffrey Hammersley5Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USADepartment of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USADepartment of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USADepartment of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USADepartment of Internal Medicine and Department of Pulmonary/Critical Care, University of Toledo Medical Center, Toledo, OH, USADepartment of Internal Medicine and Department of Pulmonary/Critical Care, University of Toledo Medical Center, Toledo, OH, USAReversible acetylcholinesterase inhibitors are used as first-line treatment for myasthenia gravis. They improve symptoms by increasing concentration of acetylcholine at the neuromuscular junction and stimulating nicotinic receptors. Serious bradyarrhythmias can occur from muscarinic stimulation in heart, which in rare cases may progress to asystole. These patients can initially be managed with hyoscyamine, a muscarinic antagonist. Persistence of bradyarrhythmias even after hyoscyamine treatment may warrant pacemaker placement. We present a case of 65-year-old female patient who presented with diplopia, dysphagia, and muscle weakness who was diagnosed with myasthenia gravis. She developed significant sinoatrial node block with prolonged asystole after starting treatment with pyridostigmine which was successfully treated with hyoscyamine, thus avoiding pacemaker placement.http://dx.doi.org/10.1155/2017/6956298 |
| spellingShingle | Mohammad Saud Khan Abhinav Tiwari Zubair Khan Himani Sharma Mohammad Taleb Jeffrey Hammersley Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine Case Reports in Cardiology |
| title | Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine |
| title_full | Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine |
| title_fullStr | Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine |
| title_full_unstemmed | Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine |
| title_short | Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine |
| title_sort | pyridostigmine induced prolonged asystole in a patient with myasthenia gravis successfully treated with hyoscyamine |
| url | http://dx.doi.org/10.1155/2017/6956298 |
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