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Clozapine related cardiomyopathy

Published online by Cambridge University Press:  07 September 2007

Waqqas A Khokhar
Affiliation:
Senior House Officer, Sheffield Care TrustUK
Kiran Rele
Affiliation:
Specialist Registrar, Sheffield Care TrustUK
Paul Birkett
Affiliation:
Honorary Consultant and Clinical Lecturer, Department of Psychiatry, University of Sheffield, UK
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Abstract

Clozapine has been found to be of superior efficacy in treatment-resistant schizophrenia. However, haematological complications of clozapine are much better known than the equally serious cardiac complications. The potential risk of cardiovascular complications persists throughout the duration of clozapine use, as compared to a higher incidence of agranulocytosis being more pronounced during the first year of treatment. We describe a case of a young male with a diagnosis of treatment-resistant schizophrenia who developed clozapine related cardiomyopathy after being maintained on the medication for about eighteen months. The only initial cardiovascular findings were sinus tachycardia on both physical and electrocardiographic examinations. Subsequent echocardiography showed evidence of impaired ventricular systolic function. A repeat echocardiogram, three months post clozapine termination, showed improved ventricular functions. Sinus tachycardia also resolved both on physical and electrocardiographic examination. A high level of clinical suspicion and clozapine withdrawal after an early cardiology liaison proved beneficial in appropriately managing this case. The case report ends with suggestions of good practice points in managing clozapine related cardiomyopathy.

Type
Case Report
Copyright
© 2007 NAPICU

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