Das Myokarditisrisiko einer Clozapin-Therapie und bei anderen atypischen Antipsychotika

Adamaszek, Michael; Olbrich, Sebastian; Hegerl, Ulrich; Schönknecht, Peter

doi:10.1055/s-0030-1266074

Cited by 7 publications

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Electrocardiogram usually shows nonspecific findings [7, 11, 13]. Echocardiography (Echo) is a helpful tool in assessing the systolic cardiac function, namely, the left ventricular ejection fraction (LVEF) [7, 10, 14, 15]. Although endomyocardial biopsy is the modality for definitive diagnosis, this is usually avoided due to the risks associated with the procedure and the possibility of missing focal myocarditis [15, 16].…”

Section: Discussionmentioning

confidence: 99%

Clozapine-Induced Cardiotoxicity Presenting as Sepsis: A Case Report and Literature Review

Khalid

Jegede

Gayam

et al. 2019

Case Reports in Medicine

View full text Add to dashboard Cite

Clozapine is an atypical antipsychotic agent indicated in the treatment of medication-resistant schizophrenia. It is often reserved as a last line of treatment owing to the potential for serious and potentially life-threatening side effects, the most serious being agranulocytosis requiring close hematological monitoring and possible discontinuation of the medication from further use in the patient even when the agranulocytosis resolves. Other complications of clozapine include sedation, weight gain, elevated triglyceride levels, postural hypotension, and tachycardia. However, the potentially serious complication of myocarditis, though rare (with an incidence of 3%), may lead to cardiomyopathy as described in our present case. We present a 21-year-old patient who was started on clozapine for management of schizophrenia. He developed fever and tachycardia and was admitted to the medical unit on intravenous antibiotics for management of sepsis as he met the criteria for systemic inflammatory response syndrome. His labs revealed an elevated troponin and trending eosinophilia, which, in the context of clozapine use, raises the suspicion of clozapine cardiotoxicity. Echocardiogram showed reduced systolic function (45%). Clozapine was immediately discontinued, and his repeat echocardiogram showed normalization of his systolic function. In view of the increased prevalence of psychiatric illnesses, internists should be aware of rare but potentially life-threatening side effects.

show abstract