ACUTE CARDIOMYOPATHY INDUCED BY THE VASODILATING ANTIHYPERTENSIVE AGENT MINOXIDIL

Minoxidil, a vasodilating antihypertensive drug, was given orally in doses of 0.5, 1.0, or 3.0 mg/kg to adult Beagle dogs on 2 consecutive days. Within 2 hr of administration, each of these doses produced hypotension and a marked tachycardia which persisted for as long as 24 hr after the second dose of minoxidil. Necropsies performed 24 hr after the second dose revealed focal, superficial areas of epicardial or endocardial hemorrhage in dogs given each of the three dose levels. Hemorrhage was associated with a mild inflammatory reaction and was not limited to the right atrium. Focal arteritis, characterized by extravasation of blood and by focal accumulation of erythrocytes and fibrin-like material in the walls of small coronary arteries, occurred in three hearts from the 3-mg/kg dose group. Myocardial necrosis was noted in one of eight dogs given the minimal pharmacologic dose of 0.5 mg/kg, and in five of eight dogs in each of the groups given 1 or 3 mg/kg. Necrosis was most frequent in the left ventricular papillary muscles, particularly the posterior one. An ischemic origin of the necrosis is suggested by the localization of the lesions and by the pharmacologic effects of minoxidil. © 1979.