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Drug-induced toxic myocarditis.

Azam Ansari1, Barry J Maron, Daniel G Berntson

  • 1The Department of Cardiovascular Medicine, Fairview Southdale Hospital, Edina, Minnesota, USA. dr_azam_ansari@hotmail.com

Texas Heart Institute Journal
|March 18, 2003
PubMed
Summary

A woman developed severe heart failure and dilated cardiomyopathy, likely due to psychiatric medications. Autopsy revealed toxic myocarditis, highlighting potential drug-induced cardiac toxicity.

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Area of Science:

  • Cardiology
  • Psychopharmacology
  • Toxicology

Background:

  • A 66-year-old woman with chronic paranoid schizophrenia developed new-onset complete left bundle branch block and congestive heart failure.
  • She had been on psychiatric medications for 10 years to manage her condition.

Observation:

  • Echocardiogram revealed dilated cardiomyopathy with severely impaired left ventricular function (ejection fraction <0.25).
  • Despite discontinuing perphenazine and amitriptyline, the patient's condition progressed.

Findings:

  • The patient died from refractory congestive heart failure two years after presentation.
  • Autopsy showed persistent toxic myocarditis with cardiac fibrosis and chronic hepatitis, considered drug-related.

Implications:

  • This case underscores the potential for certain psychotropic medications to cause severe, persistent cardiac damage.
  • Highlights the importance of monitoring cardiac function in patients on long-term psychotropic drug therapy.
  • Suggests a need for further research into the cardiotoxic mechanisms of specific psychotropic agents.

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