| Popis: |
To the Editor.— The article on longterm use of minoxidil by Mitchell and Pettinger (239:2131, 1978) describes nine of 17 current patients with an increase in heart size. Four might have been due to poor blood pressure (BP) control (and presumed progressive left ventricular enlargement), but in five there was no good explanation. I have followed up only one patient who was receiving minoxidil, but an apparent increase in heart size also developed in this man, which began within a week of starting minoxidil therapy in 1973. Within 18 months and despite absence of symptoms and with excellent BP control, the cardiac outline had reached impressive proportions. Echocardiography showed a pericardial effusion. Cardiac catheterization (done also because of reports of pulmonary hypertension with minoxidil therapy) showed no hemodynamic abnormalities. Pericardicentesis was unrevealing of infection or inflammation, though the fluid was reported as serosanguineous, and the protein level was 3.8 g/dl. |
