Clinician Update is certainly at increased cardiovascular risk. One of his prescribed medications, phentermine, acts primarily as a norepinephrine-releasing agent and centrally suppresses appetite in the hypothalamus. Because of its amphetamine-like actions, it also exerts peripheral effects of pulse and blood pressure elevation. In a patient with this degree of obesity, it is likely that the combination of sleep apnea, possibly right-sided heart overload, and phentermine effects triggered atrial fibrillation.
