Giant negative T waves during interferon therapy in a patient with chronic hepatitis C

Area of Science:

• Cardiology
• Hepatology
• Pharmacology

Background:

• Interferon-alpha (IFN-alpha) is a standard treatment for chronic hepatitis C in Japan.
• Cardiovascular adverse events are generally rare with IFN-alpha therapy.
• Monitoring for cardiac effects is crucial, even in patients with pre-existing minor cardiac conditions.

Observation:

• A 64-year-old male patient with chronic active hepatitis C experienced fatigue, palpitations, and depression during IFN-alpha treatment.
• The patient developed atrial fibrillation accompanied by significant negative T waves on ECG.
• Echocardiography revealed septal and apical hypertrophy.

Findings:

• Subjective symptoms and atrial fibrillation resolved within three days of discontinuing IFN-alpha.
• The direct causal link between IFN-alpha and the observed giant negative T waves with apical hypertrophy remains uncertain.
• The case may represent an incidental observation of hepatitis C virus (HCV)-related myocardial hypertrophy.

Implications:

• Cardiovascular toxicity associated with IFN-alpha therapy warrants careful monitoring.
• This case highlights the potential for unexpected cardiac adverse reactions in patients receiving IFN-alpha.
• Close cardiac surveillance is recommended for all patients undergoing IFN-alpha treatment, particularly those with underlying cardiac conditions.