CARDIAC TAMPONADE ASSOCIATED WITH MINOXIDIL USE IN END-STAGE RENAL DISEASE (ESRD) ON HEMODIALYSIS

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Minoxidil, a directly acting vasodilator used in treating resistant hypertension, has notable side effects including salt and fluid retention, pericarditis, occasionally pericardial effusion which may progress to tamponade rare cases. Patients with advanced renal impairment are at higher risk for developing the latter complication. We present possible case of minoxidil associated patient ESRD on hemodialysis. CASE PRESENTATION: A 38-year-old male ESRD, chronic anemia, hypertension (treated least three years) initially presented hospital fatigue, dizziness, chest tightness after missing dialysis session due his symptoms. An EKG admission revealed sinus bradycardia no ST changes; labs were mild troponin elevation 0.23. physical exam was unremarkable. There biochemical evidence uremia. Patient hypotensive required pressor support. DISCUSSION: The had been admitted recently acute symptomatic anemia secondary gastrointestinal bleed echo time showed moderate stable upon discharge. repeat during current large posterior measuring >2.5 cm. noted have early physiology based percentage change tricuspid E-velocity, but not amenable percutaneous drainage. Therefore, cardiothoracic surgery performed window. Minoxidil discontinued concerns induced effusion. readmitted 2 weeks discharge recurrent cardiac unclear reasons that He followed clinic afterwards follow up obtained 4 complete resolution CONCLUSIONS: Minoxidil-induced is an underappreciated complication occurs about 3% patients. cessation minoxidil, especially cases complicating recommended avoid tamponade. REFERENCE #1: Zarate A, Gelfand MC, Horton JD, Winchester JF, Gottlieb MJ, Lazarus JM, Schreiner GE. Pericardial therapy dialyzed Int J Artif Organs. 1980 Jan;3(1):15-7. PMID: 7353909. DISCLOSURES: No relevant relationships by Raza Hussain, source=Web Response Manar Jbara, Vindhya Sriramoju,