Article · Volume 7, Issue 1 · pp. 41–3
Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction
Vaneet Jearath1, Rajan Vashisht1, Vipul Rustagi1, Sujeet Raina1, Rajesh Sharma1
- 1Department of Medicine, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India.
Abstract
Pioglitazone‑induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre‑existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose‑related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.
Keywords: Diabetes; diabetes mellitus; heart failure; pioglitazone; thiazolidinedione
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