Severe Bradycardia caused by Octreotide in an Adolescent: A Case Report

Background and Objective: Octreotide is a somatostatin analogue used to control upper gastrointestinal (GI) bleeding. Adverse effects observed include hyperglycemia, growth hormone deficiency, hypertension, Q-T interval prolongation, and ventricular fibrillation. In rare cases, mild bradycardia has been reported. Case Report: A 16-year-old boy was admitted with shock due to hematemesis and melena a bleeding duodenal ulcer. He was treated with an intravenous venous octreotide infusion at a dose of 1 microgram/kg/hour, and bleeding was controlled with coagulation forceps and adrenaline injection. Because of rebleeding, octreotide was increased to 2 micrograms/kg/hour because of bleeding again. After 24 hours, he developed severe bradycardia (pulse rate (PR) 45/minute). His PR increased to 66/minute by 12 hours after octreotide was discontinued. Conclusion: Octreotide can cause significant cardiovascular side effects. Bradycardia and cardiac conduction blocks may affect the hemodynamics of a child with acute GI bleeding.