SHM Converge Scientific Abstract ePoster Gallery-Clozapine-Induced Myocarditis

Pdf Summary

A 44-year-old man with traumatic brain injury and schizophrenia presented with chest pain two weeks after starting clozapine. Because his symptoms were difficult to characterize, he was initially treated as a possible NSTEMI. His ECG showed no ischemic changes, but troponin was markedly elevated and C-reactive protein was also high. Echocardiogram showed normal cardiac function, and coronary CT angiography found no coronary artery disease. Cardiac MRI demonstrated mid-myocardial to sub-epicardial non-ischemic fibrosis, supporting a diagnosis of myocarditis. Clozapine was stopped, and tests for other causes of myocarditis were negative. He was discharged in stable condition after coordination with psychiatry.<br /><br />The case highlights clozapine-induced myocarditis, a rare but potentially life-threatening adverse effect that most often occurs within the first 8 weeks of treatment. Symptoms are often nonspecific and may include chest pain, fever, or tachycardia. Common findings can include elevated troponin, inflammatory markers, leukocytosis, and eosinophilia. Management is primarily immediate discontinuation of clozapine and supportive care.<br /><br />This case emphasizes the importance of a careful medication history in hospitalized patients. Clinicians should consider clozapine-induced myocarditis in any patient recently started on clozapine who develops chest pain, heart failure symptoms, or other unexplained cardiac complaints.

Asset Subtitle

Brian Petullo

Meta Tag

Author List Brian Petullo

Category Clinical Vignettes

Concept Clozapine-induced Myocarditis

Concept Myocarditis

Concept Clozapine Discontinuation

Concept Clozapine

Concept Troponin

Distinguished Non-Finalist

Presenter Organization The Ohio State University College of Medicine

Presenting Author Brian Petullo

Track Adult

Keywords

clozapine-induced myocarditis

chest pain

troponin elevation

cardiac MRI

non-ischemic fibrosis

coronary CT angiography

NSTEMI differential

inflammatory markers

schizophrenia

medication history

Clozapine-induced Myocarditis

Myocarditis

Clozapine Discontinuation

Clozapine

Troponin