SHM Converge Scientific Abstract ePoster Gallery-A Peculiar Case of Asymptomatic Myopericarditis

Pdf Summary

This case report describes a 21-year-old man with schizophrenia who developed asymptomatic myopericarditis after a recent clozapine dose increase from 75 mg to 300 mg. He was found to have elevated troponin and C-reactive protein on routine outpatient labs, with only one brief episode of self-resolving burning chest pain and persistent tachycardia on exam. Initial ECG showed sinus tachycardia, while echocardiography demonstrated normal ejection fraction and no pericardial effusion.<br /><br />Over the next day, his ECG evolved to show diffuse ST-segment elevations consistent with myopericarditis, and both troponin and CRP continued to rise. Despite these objective abnormalities, the patient remained clinically asymptomatic. In consultation with Psychiatry, clozapine was permanently discontinued and benztropine was started to reduce withdrawal effects. A repeat echocardiogram 48 hours later remained unchanged, and the patient was discharged safely.<br /><br />The discussion emphasizes that clozapine can cause a spectrum of cardiac toxicity, including pericarditis, myocarditis, myopericarditis, and severe cardiomyopathy. Risk is higher during initiation and dose escalation. Because early symptoms may be absent or nonspecific, clinicians should monitor cardiac enzymes and inflammatory markers regularly in patients receiving clozapine. Any flu-like symptoms, chest pain, dyspnea, or unexplained tachycardia should prompt further cardiac evaluation, including imaging. Early recognition and prompt discontinuation of clozapine are critical to preventing progression of cardiotoxicity.

Asset Subtitle

Tre'Cherie A. Crumbs

Meta Tag

Author List Michael A. Gallagher, Tre'Cherie A. Crumbs

Category Clinical Vignettes

Concept Clozapine

Concept Myopericarditis

Concept Cardiotoxicity

Concept Asymptomatic Myopericarditis

Concept Cardiac Enzymes

Distinguished Non-Finalist

Presenter Organization Emory University SOM

Presenting Author Tre'Cherie A. Crumbs

Track Adult

Keywords

clozapine

myopericarditis

schizophrenia

troponin

C-reactive protein

tachycardia

ECG

myocarditis

cardiotoxicity

dose escalation

Clozapine

Myopericarditis

Cardiotoxicity

Asymptomatic Myopericarditis

Cardiac Enzymes