This case report suggests that long-term, low-dose clozapine therapy may be a rare etiology for the development of heart failure with preserved ejection fraction (HFpEF).
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May warrant vigilance for HFpEF in clozapine users; leaves open causal association pending prospective data.
We present the case of a 55-year-old female, on very low dose Clozapine treatment for Schizophrenia, who presented with shortness of breath and in atrial fibrillation and with no previous history of cardiac failure. Chest X Ray showed evidence of bilateral pulmonary oedema and bilateral pleural effusion, and a diagnosis of acute heart failure with preserved ejection fraction was made based on echocardiographic findings and raised brain naturetic peptide (BNP) levels. This was the patient’s first presentation to hospital with heart failure related symptoms. Initial medical management included diuretics which did not improve her symptoms. With no other aetiology obvious her clozapine was stopped.
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Mohammed Irshad Khan (2021) studied this question.
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