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Hydroxychloroquine and Cardiotoxicity
Subo Dey1, Kyu-In Lee2, Sarah Subhan1
1From the Departments of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Cardiology in Review
|March 22, 2023
Summary
Hydroxychloroquine (HCQ) can cause heart damage, including cardiomyopathy, especially with long-term use. Current medical guidelines lack recommendations for monitoring cardiac function during HCQ treatment.
Area of Science:
- Rheumatology
- Cardiology
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) is a common treatment for autoimmune diseases like lupus and rheumatoid arthritis.
- HCQ works by modulating the immune system through cytokine and MHC interaction.
- While effective, HCQ carries risks, particularly cardiotoxicity with prolonged use or high doses.
Purpose of the Study:
- To review the cardiotoxic effects of Hydroxychloroquine (HCQ).
- To describe the pathological findings of HCQ-induced cardiotoxicity.
- To highlight the lack of current monitoring guidelines for HCQ cardiotoxicity.
Main Methods:
- Literature review of Hydroxychloroquine (HCQ) cardiotoxicity.
- Analysis of common cardiac biopsy findings in HCQ toxicity.
- Examination of existing rheumatology and cardiology guidelines.
Main Results:
- Prolonged HCQ use is associated with cardiac issues like arrhythmias and cardiomyopathy.
- Cardiac biopsies show characteristic cellular changes, including vacuolation and specific ultrastructural bodies.
- There are no established guidelines for routine cardiac monitoring in patients on HCQ.
Conclusions:
- HCQ cardiotoxicity is an underrecognized complication of treatment.
- Specific pathological findings aid in diagnosing HCQ-induced heart damage.
- Development of monitoring guidelines is crucial for patient safety.
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