title: Chloroquine-induced cardiomyopathy-echocardiographic features.
abstract: A 61-year-old woman with a 30-year history of systemic lupus erythematosus treated with chloroquine sulfate presented with complete heart block, congestive heart failure, and findings of restrictive cardiomyopathy on echocardiogram. Thickening of mitral, aortic, and tricuspid valves along with mild to moderate valve regurgitation was also present. Magnetic resonance imaging showed increased gadolinium uptake in the interventricular septum and the left ventricular lateral wall. Endomyocardial biopsy specimen showed marked myocardial cytoplasmic vacuolation and extensive myelin figures. Seven months after discontinuation of chloroquine, she showed significant clinical improvement and reversal of cardiomyopathy on echocardiography. This is the first case report describing a cardiomyopathy with prolonged use of chloroquine involving the conduction system, cardiac valves, and the myocardium with reversal on discontinuation of the drug.
authors.affiliation: Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. tasneem.naqvi@cshs.org
authors.forename: Tasneem Z
authors.initials: TZ
authors.lastname: Naqvi
authors.forename: Daniel
authors.initials: D
authors.lastname: Luthringer
authors.forename: Alberto
authors.initials: A
authors.lastname: Marchevsky
authors.forename: Rola
authors.initials: R
authors.lastname: Saouf
authors.forename: Khawar
authors.initials: K
authors.lastname: Gul
authors.forename: Neil A
authors.initials: NA
authors.lastname: Buchbinder
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects*; D002313:Cardiomyopathy, Restrictive / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D002738:Chloroquine / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D002738:Chloroquine