Early Manifestation of Clozapine-Induced Cardiotoxicity: Detection, Pathophysiology, and Management Article Swipe
Steven P. Hamilton
,
Rana A Tauseen
,
Natale Wasef
,
A. Wolf
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.7759/cureus.27202
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.7759/cureus.27202
Schizoaffective disorder, bipolar type is a chronic mental health disorder that may manifest as mania. Clozapine is effective in treating acute mania and in achieving mood stabilization. However, on rare occasions, the use of clozapine has been associated with cardiotoxicity. Here, we present a case of a 31-year-old man who at baseline is known to have schizoaffective disorder, bipolar type, and cannabis dependence and was admitted to our hospital with a psychotic relapse. He was treated with clozapine, uptitrated to a maximum daily dose of 200mg twice daily by day 10. Thereafter he became febrile and experienced malaise, myalgias, and chest pain. He was noted on electrocardiogram to have sinus tachycardia without ischemic changes. In this context, he had a troponin leak, increased white blood cell count, serologies and cultures were negative and chest x-ray revealed no acute disease of the chest. Due to the suspicion of clozapine-induced cardiotoxicity, a transthoracic echocardiogram was done, which revealed mildly depressed left ventricular (LV) systolic function without pericardial effusion. Thereafter, clozapine was withdrawn and switched to lithium. Additionally, the cardioselective, metoprolol tartrate was initiated. Within 36-48 hours, he had resolution of symptoms and remained cardiovascularly stable. Clozapine uncommonly causes cardiotoxicity and early features may be non-specific. Awareness of this and recognizing early features aids in reducing the associated cardiovascular morbidity and mortality.
Related Topics
Concepts
Medicine
Clozapine
Schizoaffective disorder
Bipolar disorder
Chest pain
Context (archaeology)
Cardiotoxicity
Internal medicine
Hypomania
Ventricular tachycardia
Sinus tachycardia
Mania
Cardiology
Palpitations
Lethargy
Anesthesia
Schizophrenia (object-oriented programming)
Psychiatry
Lithium (medication)
Psychosis
Biology
Paleontology
Chemotherapy
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.7759/cureus.27202
- https://www.cureus.com/articles/65229-early-manifestation-of-clozapine-induced-cardiotoxicity-detection-pathophysiology-and-management.pdf
- OA Status
- diamond
- Cited By
- 1
- References
- 9
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4286817207
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4286817207Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.7759/cureus.27202Digital Object Identifier
- Title
-
Early Manifestation of Clozapine-Induced Cardiotoxicity: Detection, Pathophysiology, and ManagementWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-07-24Full publication date if available
- Authors
-
Steven P. Hamilton, Rana A Tauseen, Natale Wasef, A. WolfList of authors in order
- Landing page
-
https://doi.org/10.7759/cureus.27202Publisher landing page
- PDF URL
-
https://www.cureus.com/articles/65229-early-manifestation-of-clozapine-induced-cardiotoxicity-detection-pathophysiology-and-management.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
diamondOpen access status per OpenAlex
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https://www.cureus.com/articles/65229-early-manifestation-of-clozapine-induced-cardiotoxicity-detection-pathophysiology-and-management.pdfDirect OA link when available
- Concepts
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Medicine, Clozapine, Schizoaffective disorder, Bipolar disorder, Chest pain, Context (archaeology), Cardiotoxicity, Internal medicine, Hypomania, Ventricular tachycardia, Sinus tachycardia, Mania, Cardiology, Palpitations, Lethargy, Anesthesia, Schizophrenia (object-oriented programming), Psychiatry, Lithium (medication), Psychosis, Biology, Paleontology, ChemotherapyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1Per-year citation counts (last 5 years)
- References (count)
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9Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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