Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas? A cohort study

MF Raphael, CC Breugem, FAE Vlasveld, M de Graaf, MG Slieker, Suzanne Pasmans, JMPJ Breur

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Background: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects. Objectives: We sought to analyze cardiovascular evaluations in patients with IH at baseline and during treatment with an oral beta-blocker. Methods: Data from 109 patients with IH were retrospectively analyzed. Patient and family history, pretreatment electrocardiogram (ECG), heart rate, and blood pressure were evaluated before initiation of beta-blocker therapy. Blood pressure and standardized questionnaires addressing side effects were evaluated during treatment. Results: Questionnaire analyses (n = 83) identified 3 cases with a family history of cardiovascular disease in first-degree relatives. ECG findings were normal in each case and no serious complication of therapy occurred. ECG abnormalities were found in 6.5% of patients but there were no contraindications to beta-blocker therapy and no major complications. Hypotension in 9 patients did not require therapy adjustment. In all, 88 parents (81%) reported side effects during beta-blocker treatment. Limitations: The relatively small patient cohort is a limitation. Conclusion: Pretreatment ECG is of limited value for patients with an unremarkable cardiovascular history and a normal heart rate and blood pressure. Hypotension may occur during treatment.
Original languageUndefined/Unknown
Pages (from-to)465-472
Number of pages8
JournalJournal of the American Academy of Dermatology
Issue number3
Publication statusPublished - 2015

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