[Acute cardiac failure due to itraconazole]

Area of Science:

• Pharmacology
• Cardiology
• Infectious Diseases

Background:

• Itraconazole is a widely used azole antifungal for treating fungal infections like aspergillosis.
• Cardiac failure is a recognized but rare adverse effect associated with itraconazole therapy.
• Previous reports often linked this complication to pre-existing cardiovascular risk factors or polypharmacy.

Observation:

• This report details a case of a patient who developed cardiac failure during itraconazole treatment.
• Crucially, the patient had no identifiable cardiovascular risk factors.
• Pre-treatment cardiac evaluations, including stress testing and echocardiography, were normal.

Findings:

• The patient experienced cardiac failure during itraconazole therapy.
• The cardiac failure resolved completely without any lasting heart damage.
• This occurred despite a lack of pre-existing cardiovascular conditions or abnormalities.

Implications:

• Cardiac failure can occur as a complication of itraconazole treatment, even in individuals with no prior cardiac issues.
• This case underscores the importance of monitoring cardiac function in patients receiving itraconazole, irrespective of their baseline cardiovascular status.
• Further investigation may be warranted to elucidate the precise mechanisms underlying itraconazole-induced cardiotoxicity.