Case Report

Bilateral Upper Extremity Thrombophlebitis Related to Intravenous Amiodarone

Authors: Omar Aljitawi, MD, Baha Shabaneh, MD, Jack Whitaker, MD

Abstract

A 47-year-old male had bilateral upper extremity thrombophlebitis after use of intravenous amiodarone for sustained ventricular tachycardia complicating myocardial infarction. Intravenous amiodarone has been widely used since it was introduced 20 years ago for severe intractable arrhythmias. Superficial thrombophlebitis was frequently noted in the early case reports when high-dose intravenous amiodarone was used. Superficial thrombophlebitis could extend hospitalization and become a significant source of distress to our patients. Some authors recommend insertion of a central line to administer intravenous amiodarone especially with expected extended use of therapy. The treating physician should be vigilant and switch from intravenous therapy to oral therapy as soon as the patient's condition stabilizes and oral therapy can be started.


Key Points


* Intravenous amiodarone has been extensively used to treat various arrhythmias. It is associated with severe local reaction at the intravenous site, especially with high-dose therapy given through a peripheral line for an extended period of time.


* Superficial thrombophlebitis could extend hospitalization and become a significant source of distress to our patients.


* To avoid thrombophlebitis related to intravenous amiodarone, some authors recommend insertion of a central line to administer intravenous amiodarone, especially with expected extended use of therapy.


* Oral amiodarone has excellent bioavailability, is significantly less expensive than intravenous preparations, and could be safely used in stable arrhythmias.

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