Dilated cardiomyopathy: an unusual complication of clozapine therapy.
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 Clozapine therapy was withdrawn.
Makhoul
Badira
B
Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel.
Hochberg
Irit
I
Rispler
Shmuel
S
Azzam
Zaher S
ZS
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
D014150:Antipsychotic Agents; D002317:Cardiovascular Agents; D003024:Clozapine