A Patient Responding to Combined Therapy with Pirmenol and Midodrine for Refractory Neurally Mediated Syncope Complicated by Prostatic Hypertrophy

Authors: Mizuguchi, Yukio¹; Ishimoto, Takeo²; Kageyama, Norihito²; Oishi, Yoshifumi²; Emi, Shigefumi²; Nagase, Norio²; Oki, Takashi²

Source: Cardiovascular Drugs and Therapy, Volume 18, Number 5, September 2004 , pp. 405-408(4)

Publisher: Springer

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Abstract:

A 67-year-old man with neurally mediated syncope (NMS) complicated by prostatic hypertrophy responded well to combined therapy with pirmenol and midodrine. In 2003, syncope occurred while the patient was driving a car. Results of head-up tilt-table testing (HUT) suggested a mixed type of NMS. Oral administration of disopyramide provided severe urinary obstruction. Pirmenol treatment was not associated with syncope during ordinary HUT, but nausea, sweating, and syncope occurred during HUT with provocative administration of isosorbide dinitrate. Combined therapy with pirmenol and midodrine avoided syncope during HUT, and has prevented attacks since discharge from the hospital.

Keywords: neurally mediated syncope; prostatic hypertrophy; pirmenol; midodrine; head-up tilt-table testing

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s10557-005-5066-8

Affiliations: 1: Cardiovascular Section, 011011011011011011011011Higashi Tokushima National Hospital, National Hospital Organization, Tokushima, 011011011011011011011011011Japan, Email: mizuguchi@higasitokusima.hosp.go.jp 2: Cardiovascular Section, 011011011011011011011011Higashi Tokushima National Hospital, National Hospital Organization, Tokushima, 011011011011011011011011011Japan,

Publication date: 2004-09-01