Amlodipine causing symptomatic bradycardia in a healthy 71-year-old male

Abstract

Amlodipine is a calcium channel blocker that is well known to be vasoselective, thereby having minimal effects in cardiac tissue. However, recent literature have reported cases of symptomatic bradycardia associated with amlodipine use. We present a case of an otherwise healthy 71-year-old male who was found to have symptomatic bradycardia while taking amlodipine. He underwent comprehensive evaluation including an exercise stress echocardiogram during which he demonstrated chronotropic competence. Amlodipine was discontinued with return of his heart rate to baseline levels after 24 hours. There is a very low reported incidence of amlodipine-induced bradycardia (0.89% of cases). Despite its infrequency, it is important to recognize amlodipine-induced bradycardia as simply discontinuing the drug will lead to complete resolution of symptoms. Failure to recognize this side effect may lead to unnecessary healthcare costs and negatively impact patient outcomes.