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Coronary Artery Syndromes After Sudden Propranolol Withdrawal
- EDWIN L. ALDERMAN, M.D.;
- D. JOHN COLTART, M.D., M.R.C.P.;
- GEORGE E. WETTACH, M.D.; and
- DONALD C. HARRISON, M.D.
Abstract
Six patients with stable exertional angina pectoris immediately developed unstable angina after cessation of propranolol therapy. The character and frequency of the pain episodes were significantly worse than those that the patients had experienced either before or during propranolol treatment. Four patients had acute coronary events (myocardial infarction in three and sudden death in one) after 2 to 21 days of continuing unstable angina. Two patients returned to their usual clinical state when propranolol therapy was recommenced. All patients had moderately severe angina before treatment and had shown excellent clinical responses to propranolol therapy. In our experience propranolol withdrawal syndromes have been an uncommon problem that may occasionally be seen in patients discontinuing medication before coronary arteriography or surgery.
Article and Author Information
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▸From the Cardiology Division of the Stanford University School of Medicine, Stanford, California; the Royal Postgraduate Medical School, Hammersmith Hospital, London, England; and the Veterans Administration Hospital, Palo Alto, California.
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▸Address reprint requests to Edwin L. Alderman, M.D., Cardiology Division, Stanford University School of Medicine, Stanford, CA 94305.
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- Received May 6, 1974.
- Accepted July 8, 1974.
