title: Dilated cardiomyopathy: an unusual complication of clozapine therapy.
abstract: BACKGROUND
  A 42-year-old obese man presented with acute pulmonary edema. He had a history of chronic residual schizophrenia for which he had been taking clozapine for 7 years, but had no known prior cardiac disease. Echocardiography demonstrated severe biventricular systolic and diastolic dysfunction with severe left ventricular enlargement. Cardiac catheterization showed no coronary artery disease.
  
  
  METHODS
  Physical examination, chest radiography, electrocardiography, transthoracic echocardiography, laboratory testing, viral serology, cardiac catheterization, coronary angiography and abdominal and renal ultrasonography.
  
  
  METHODS
  Clozapine-induced dilated cardiomyopathy.
  
  
  RESULTS
  Intravenous nesiritide, furosemide and morphine followed by oral heart-failure therapy comprising ramipril, metoprolol succinate, spironolactone, and furosemide. Clozapine therapy was withdrawn.
authors.affiliation: Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Badira
authors.initials: B
authors.lastname: Makhoul
authors.forename: Irit
authors.initials: I
authors.lastname: Hochberg
authors.forename: Shmuel
authors.initials: S
authors.lastname: Rispler
authors.forename: Zaher S
authors.initials: ZS
authors.lastname: Azzam
mesh_terms: D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D002317:Cardiovascular Agents / Q000008:administration & dosage; D003024:Clozapine / Q000009:adverse effects*; D017023:Coronary Angiography; D004452:Echocardiography; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011654:Pulmonary Edema / Q000139:chemically induced; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D002317:Cardiovascular Agents; D003024:Clozapine