Garg Abhinav, Bath Anandbir S, Kalavakunta Jagadeesh K
Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Cardiology, Ascension Borgess Hospital, Kalamazoo, USA.
Cureus. 2020 Apr 30;12(4):e7901. doi: 10.7759/cureus.7901.
Clozapine is a dibenzodiazepine antipsychotic used for treatment-resistant schizophrenia. Its association with several side effects such as agranulocytosis, seizure, and insulin resistance is well known. Cardiac side effects such as myocarditis and cardiomyopathy are less common and have been seldom reported. Here we report an unusual case of clozapine-induced nonischemic dilated cardiomyopathy. A 50-year-old female with treatment-resistant schizophrenia on clozapine presented with gradually worsening shortness of breath, productive cough, and pleuritic chest pain. She was found to have non-ischemic dilated cardiomyopathy due to clozapine use as no other causative factor was found. Clozapine was gradually tapered and then discontinued. Repeat echocardiogram in three months revealed improvement in ejection fraction. This case is unique as it outlines clozapine as a rare cause of nonischemic cardiomyopathy, as discontinuation of the drug showed improvement in symptoms and heart function.
氯氮平是一种用于治疗难治性精神分裂症的二苯并二氮䓬类抗精神病药物。它与粒细胞缺乏症、癫痫发作和胰岛素抵抗等多种副作用有关，这是众所周知的。心肌炎和心肌病等心脏副作用不太常见，报道也很少。在此，我们报告一例氯氮平诱发的非缺血性扩张型心肌病的罕见病例。一名50岁患有难治性精神分裂症且正在服用氯氮平的女性，出现了逐渐加重的呼吸急促、咳痰和胸膜炎性胸痛。由于未发现其他致病因素，她被诊断为因服用氯氮平导致的非缺血性扩张型心肌病。氯氮平逐渐减量后停药。三个月后复查超声心动图显示射血分数有所改善。该病例很独特，因为它明确了氯氮平是导致非缺血性心肌病的罕见原因，停药后症状和心脏功能有所改善。
