[Malignant hypertension and cardiac decompensation after overuse of nasal decongestant: A case report and literature review]

Rev Med Interne. 2016 Jun;37(6):424-8. doi: 10.1016/j.revmed.2015.09.010. Epub 2015 Oct 31.
[Article in French]

Abstract

Introduction: Vasoconstrictors, widely prescribed in the congestive states during acute rhinitis, are responsible for many cases of drug-related iatrogenic disease.

Case report: We report the case of a 40-year-old man, who presented with an episode of malignant hypertensive crisis associated with life-threatening congestive heart decompensation. The patient interview revealed consumption to supra-therapeutic dosage of an association of naphazoline and prednisolone nasal sprays. The diagnostic work-up allowed to rule out disease-related causes of secondary hypertension. The drug-related disease was thus retained.

Conclusion: The results of the literature review showed many cases of vasoconstrictor poisoning responsible for central nervous system and cardiovascular involvement, especially in young children. This first case of heart failure related to nasal decongestant administration increases the scope of potentially serious risks of these drugs and demonstrates the outreach needs for health professionals and patients about their proper use.

Keywords: Heart failure; Hypertension; Hypertension artérielle; Insuffisance cardiaque; Naphazoline; Nasal sprays; Pulvérisations nasales; Toxicity; Toxicité.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Heart Failure / chemically induced*
  • Heart Failure / complications
  • Heart Failure / pathology
  • Humans
  • Hypertension, Malignant / chemically induced*
  • Hypertension, Malignant / complications
  • Hypertension, Malignant / pathology
  • Male
  • Naphazoline / adverse effects
  • Nasal Decongestants / adverse effects*
  • Prednisolone / adverse effects
  • Prescription Drug Overuse / adverse effects*

Substances

  • Nasal Decongestants
  • Prednisolone
  • Naphazoline