Cardiac Damage from Chronic Use of Chloroquine: A Case Report and Review of the Literature

Teixeira, Ricardo Alkmim; Filho, Martino Martinelli; Benvenuti, Luiz Alberto; Costa, Roberto; Pedrosa, Anísio; Nishioka, Silvana

doi:10.1590/s0066-782x2002001000009

Cited by 39 publications

(31 citation statements)

References 16 publications

(15 reference statements)

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“…To date, reports have been published on 35 patients with biopsy-proven cardiomyopathy 7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36 and on 30 patients with total AV block only 9,30,37,38 . Moreover, 12 of those patients with cardiomyopathy exhibited complete AV block as well (Table 1).…”

Section: Rheumatologymentioning

confidence: 99%

Cardiomyopathy Caused by Longterm Treatment with Chloroquine: A Rare Disease, or a Rare Diagnosis?

Tönnesmann¹,

Stroehmann²,

Kandolf³

et al. 2012

J Rheumatol

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Section: Rheumatologymentioning

confidence: 99%

Cardiomyopathy Caused by Longterm Treatment with Chloroquine: A Rare Disease, or a Rare Diagnosis?

Tönnesmann¹,

Stroehmann²,

Kandolf³

et al. 2012

J Rheumatol

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“…Cardiac complications are uncommon, but there have been several reports on potential life-threatening rhythm disturbances associated with chronic chloroquine use; these include conduction abnormalities, complete AVB, QT interval prolongation and torsades de pointes (3,5,6). Major arrhythmias caused by chronic chloroquine use have been related to a significant reduction in the cardiac rate, increases in the action potential duration and refractory period of Purkinje fibers (7).…”

Section: Discussionmentioning

confidence: 99%

Klorokin Tedavisine Bağlı Üçüncü Derece Atriyoventriküler Blok

İslamoğlu¹,

Yazıcı²,

Çil³

et al. 2011

Tftr

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A 67-year-old woman on long-term chloroquine treatment for rheumatoid arthritis presented with dizziness and syncope. Although her medical history revealed no cardiovascular disease, complete atrioventricular block was detected by electrocardiography. Chloroquine was discontinued. Three days later, complete atrioventricular block spontaneously resolved to sinus rhythm. Cardiac complications associated with chronic chloroquine use are uncommon, nevertheless, there have been several reports on potential lifethreatening rhythm disturbances and/or cardiomyopathy. In our case, atrioventricular block was associated with chronic chloroquine use. Cardiac evaluation with electrocardiography must be done for conduction disorders in patients using chloroquine for rheumatic diseases.

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“…Immuno-mediated damage, atherosclerotic complications, or even adverse effect of the treatment (chloroquine-induced cardiotoxicity) seem to be the mechanisms involved more often in the pathophysiology of those disturbances. [1][2][3][4] As a rule, the literature has not given proper clinical attention to the development of arrhythmias in those patients. 5 So far, the evidence related to electrocardiographic disturbances is restricted to studies with small number of patients, although cardiac involvement can affect up to 50% of the cases.…”

Section: Introductionmentioning

confidence: 99%

Eventos arrítmicos no lúpus eritematoso sistêmico

Teixeira¹,

Borba²,

Bonfá³

et al. 2010

Rev. Bras. Reumatol.

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Cardiac involvement is present in more than half of the patients with Systemic Lupus Erythematosus (SLE). However, studies on the prevalence of arrhythmias in this disease and laboratorial correlations predictive of their development do not exist. It seems possible that the classic second mortality peak is related to arrhythmias, mainly due to the sudden nature of those deaths. Autoimmune process, atherosclerotic complications, and even adverse effects secondary to the treatment of this disorder (chloroquine cardiotoxicity) seem to be the main pathophysiological mechanisms of those disturbances. The direct participation of autoantibodies, such as anti-Ro/SSA and anti-RNP, is still controversial. All types of AV blocks (AVB), intraventricular conduction disturbances, and sick sinus syndrome have already been described in this disease. Tachycardias identified more often include sinus tachycardia, atrial fibrillation, and atrial ectopies. Long QT syndrome and the presence of late potentials in signal-averaged ECG have also been described in SLE patients and they can be associated with increased mortality rates. Cardiac toxicity secondary to chloroquine could be responsible for several types of arrhythmias. However, few cases of fascicular block evolving to complete AV block have been described. Since these adverse effects are rarely reported, the beneficial anti-inflammatory and immune properties support the use of antimalarials in this disease. A complete cardiologic evaluation should include the conduction system and must be carried out in all SLE patients to identify arrhythmias, therefore preventing symptoms and also sudden cardiac death.

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Cardiac Damage from Chronic Use of Chloroquine: A Case Report and Review of the Literature

Cited by 39 publications

References 16 publications

Cardiomyopathy Caused by Longterm Treatment with Chloroquine: A Rare Disease, or a Rare Diagnosis?

Cardiomyopathy Caused by Longterm Treatment with Chloroquine: A Rare Disease, or a Rare Diagnosis?

Klorokin Tedavisine Bağlı Üçüncü Derece Atriyoventriküler Blok

Eventos arrítmicos no lúpus eritematoso sistêmico

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