ABSTRACT

Milrinone is a phosphodiesterase III inhibitor which is used very often in pediatric cases post-cardiac operation and in intensive care unit for hemodynamic support. However it is known that Milrinone has side effects such as headache, angina, hypotension, anaphylaxis, hypokalemia, deterioration of liver functions, thrombocytopenia, as well as supraventricular tachycardia, ventricular tachycardia, torsade de pointes, atrial fibrillation and sometimes ventricular fibrillation.

Here we present one year old patient admitted to the PICU for cardiomyopathy and heart failure. Milrinone infusion started for hemodynamic support. Shortly after milrinone infusion started, he developed ventricular fibrillation (VF). After the patient stabilized, milrinone infusion was started again. However, shortly after starting of milrinone infusion for the second time, VF recurred. Then, milrinone was discontinued. No recurrence was observed following milrinone discontinuation. Development of VF two times shortly after starting of milrinone infusion and the absence of recurrence of VF following milrinone discontinuation lead us to believe that the life threatening VF was caused by milrinone.

We thought fit to present the case due to the contribution it might bring to the intensive care practice by keeping in mind life threatening arrhythmias related to milrinone.

Keywords: Milrinone, arrhythmia, cardiomyopathy