Cardiovascular Drugs in Management of Infantile Hemangiomas

Infantile hemangiomas (IHs) are the most common benign vascular tumors in children. IHs are generally noticed within the first few days to months of life and are characterized by a rapid growth phase followed by an involution phase. Despite their benign and selflimited nature, some hemangiomas can be life-threatening, may cause complications such as ulceration and permanent disfigurement that requires the immediate treatment. Recently, propranolol, a nonselective β-blocker, has become a successful and safe treatment for IHs. The mechanism of action on IHs still remains unclear, although several mechanisms are suggested which includes vasoconstriction, inhibition of angiogenesis and inducement of apoptosis. More recently other cardiovascular drugs, such as nadolol, atenolol and captopril, have been explored for the same purpose. The reviewed literature implies that propranolol as well as selective b-blockers should be used as first-line therapy for treating IHs. Additional randomized controlled trails are necessary to explore long-term effects.