[Drug-induced heart failure]

Although heart failure is predominantly caused by cardiovascular disorders, several classes of drugs may induce heart failure in patients with pre-existing normal left ventricular function or may precipitate the occurrence of heart failure in patients with left ventricular impairment. These drugs are predominantly those belonging to the categories of cytostatics, anti-arrhythmics, beta-blockers, nonsteroidal anti-inflammatory drugs, calcium channel blockers and anaesthetics. Drug-induced heart failure should be regarded as a potentially preventable cause of heart failure, although sometimes therapeutic alternatives are scarce (e.g. anthracycline-induced cardiomyopathy). Awareness of the possibility of adverse effects on cardiac performance by several classes of drugs, particularly in patients with pre-existing ventricular impairment, may contribute to prevention or timely diagnosis and treatment of drug-induced heart failure.