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Masked clozapine-induced cardiomyopathy
Charles A Pastor1, Monica Mehta
1Family Medicine Department, Bronx-Lebanon Hospital Center, Bronx, New York 10456, USA. cpastor@bronxleb.org
Journal of the American Board of Family Medicine : JABFM
|January 8, 2008
Summary
Antipsychotic medications like clozapine can cause heart failure (cardiomyopathy) in susceptible individuals. Promptly stopping these drugs can significantly improve cardiac function.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Antipsychotic medications are crucial for managing psychosis and mood disorders.
- Cardiomyopathy is a known but poorly understood adverse effect of some antipsychotics.
- This case involves a patient with no prior cardiac history.
Observation:
- A 33-year-old Latin-American woman developed heart failure after 6 weeks of clozapine and olanzapine.
- Her symptoms were initially ambiguous, delaying diagnosis.
- She had a history of psychosis and mood disorder.
Findings:
- Cardiac function improved significantly after discontinuing clozapine and olanzapine, with ejection fraction rising from 38% to 53%.
- Comprehensive work-up ruled out other causes of heart failure.
- This is the second reported case of clozapine-induced cardiomyopathy in a Latin-American woman.
Implications:
- Highlights the potential for antipsychotic-induced cardiomyopathy, even in patients without cardiac risk factors.
- Emphasizes the need for vigilant cardiac monitoring in patients on clozapine and olanzapine.
- Underscores the importance of considering drug-induced causes in ambiguous heart failure presentations.
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