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Hydroxychloroquine-induced cardiomyopathy: case report, pathophysiology, diagnosis, and treatment

Haran Yogasundaram1, Brendan N Putko1, Julia Tien2

  • 1Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.

The Canadian Journal of Cardiology
|December 6, 2014
PubMed

Insights

Long-term hydroxychloroquine use can cause drug-induced cardiomyopathy, a lysosomal storage disorder. Early detection through regular cardiac screening is crucial for managing this serious adverse effect.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pharmacology

Background:

  • Hydroxychloroquine (HCQ) is widely used for autoimmune diseases like lupus and rheumatoid arthritis.
  • Long-term HCQ treatment poses risks, including cardiac toxicity.
  • Understanding HCQ's mechanisms is key to managing its adverse effects.

Observation:

  • HCQ can lead to acquired lysosomal storage disorders.
  • Cardiac manifestations include concentric hypertrophy and conduction abnormalities.
  • Early recognition and withdrawal of HCQ are vital for reversibility.

Findings:

  • Chronic HCQ use is linked to drug-induced cardiomyopathy.
  • Screening with ECG and echocardiography can detect cardiac changes.
  • Cardiac MRI and biopsy aid in diagnosis and prognosis.

Implications:

  • Regular cardiac monitoring is essential for patients on long-term HCQ.
  • Prompt identification of HCQ-induced cardiomyopathy improves outcomes.
  • Awareness of HCQ cardiotoxicity is critical for patient safety and management.

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