A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder
We present a case of drug-induced myocarditis manifesting as acute heart failure in a young patient with bipolar disorder being treated for depression. The case describes a 20-year-old man being treated in the psychiatry ward for worsening depression when he started complaining of chest pain and sho...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2015/283156 |
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| author | Ronny Cohen Alla Lysenko Thierry Mallet Brooks Mirrer Michael Gale Pablo Loarte Robert McCue |
| author_facet | Ronny Cohen Alla Lysenko Thierry Mallet Brooks Mirrer Michael Gale Pablo Loarte Robert McCue |
| author_sort | Ronny Cohen |
| collection | DOAJ |
| description | We present a case of drug-induced myocarditis manifesting as acute heart failure in a young patient with bipolar disorder being treated for depression. The case describes a 20-year-old man being treated in the psychiatry ward for worsening depression when he started complaining of chest pain and shortness of breath. His list of medications included clozapine, lithium, lorazepam, and haloperidol. The main findings on physical examination were tachycardia, low-grade fever, crackles in both lung bases on auscultation, and the absence of any notable edema. Abnormal labs included a troponin of 0.9, with a CK of 245 and CK-MB of 3.1. An ECG revealed sinus tachycardia and left anterior fascicular block (LAFB). An echocardiogram revealed global hypokinesis, severe left ventricular dysfunction with an ejection fraction estimated at 20%. The patient had an admitting diagnosis of acute left ventricular systolic dysfunction likely secondary to drug-induced myocarditis (suspect clozapine) versus acute coronary syndrome. He was managed conservatively and transferred to another facility for endomyocardial biopsy confirming myocarditis. This case is an example of one of the most typical presentations of suspected drug-induced acute myocarditis and will hopefully prompt the reader to think of this underdiagnosed entity in the right clinical setting. |
| format | Article |
| id | doaj-art-269407be382546ce91307a2b672aee9e |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-269407be382546ce91307a2b672aee9e2025-02-03T05:50:59ZengWileyCase Reports in Cardiology2090-64042090-64122015-01-01201510.1155/2015/283156283156A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar DisorderRonny Cohen0Alla Lysenko1Thierry Mallet2Brooks Mirrer3Michael Gale4Pablo Loarte5Robert McCue6Chief of Cardiology, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USAPharmacy Department, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USADepartment of Medicine, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USADivision of Cardiology, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USADepartment of Medicine, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USADepartment of Internal Medicine, Yale-New Haven Hospital, 20 York Street, New Haven, CT 06510, USAWoodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USAWe present a case of drug-induced myocarditis manifesting as acute heart failure in a young patient with bipolar disorder being treated for depression. The case describes a 20-year-old man being treated in the psychiatry ward for worsening depression when he started complaining of chest pain and shortness of breath. His list of medications included clozapine, lithium, lorazepam, and haloperidol. The main findings on physical examination were tachycardia, low-grade fever, crackles in both lung bases on auscultation, and the absence of any notable edema. Abnormal labs included a troponin of 0.9, with a CK of 245 and CK-MB of 3.1. An ECG revealed sinus tachycardia and left anterior fascicular block (LAFB). An echocardiogram revealed global hypokinesis, severe left ventricular dysfunction with an ejection fraction estimated at 20%. The patient had an admitting diagnosis of acute left ventricular systolic dysfunction likely secondary to drug-induced myocarditis (suspect clozapine) versus acute coronary syndrome. He was managed conservatively and transferred to another facility for endomyocardial biopsy confirming myocarditis. This case is an example of one of the most typical presentations of suspected drug-induced acute myocarditis and will hopefully prompt the reader to think of this underdiagnosed entity in the right clinical setting.http://dx.doi.org/10.1155/2015/283156 |
| spellingShingle | Ronny Cohen Alla Lysenko Thierry Mallet Brooks Mirrer Michael Gale Pablo Loarte Robert McCue A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder Case Reports in Cardiology |
| title | A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder |
| title_full | A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder |
| title_fullStr | A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder |
| title_full_unstemmed | A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder |
| title_short | A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder |
| title_sort | case of clozapine induced myocarditis in a young patient with bipolar disorder |
| url | http://dx.doi.org/10.1155/2015/283156 |
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