Clozapine induced myopericarditis: early recognition improves clinical outcome

Am J Ther. 2006 May-Jun;13(3):274-6. doi: 10.1097/01.mjt.0000212704.79248.3d.

Abstract

Clozapine is an atypical dibenzodiazepine antipsychotic used for resistant schizophrenia. Uncommonly, it is associated with myocarditis. We report a case of myopericarditis masquerading as an acute myocardial infarction based on presenting electrocardiogram and cardiac markers. Emergent coronary angiography confirmed the absence of epicardial coronary occlusion and revealed severe left ventricular systolic dysfunction. Immediate discontinuation of the clozapine, along with aggressive supportive care resulted in complete recovery to baseline. Cardiovascular health professionals should be aware of this uncommon but serious side effect of clozapine since failure to recognize the association may result in adverse clinical outcome and inappropriate therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Clozapine / adverse effects*
  • Diagnosis, Differential
  • Electrocardiography
  • Humans
  • Male
  • Myocardial Infarction / diagnosis
  • Myocarditis / chemically induced*
  • Myocarditis / diagnostic imaging
  • Myocarditis / physiopathology
  • Ultrasonography

Substances

  • Antipsychotic Agents
  • Clozapine