查看文章

Discussion

Chloroquine and HCQ were initially used as antimalarial, but nowadays they have become mainstays in the treatment of rheumatic diseases, especially RA and systemic lupus erythematosus. Clinical manifestations of antimalarial-induced cardiotoxicity can manifest as restrictive cardiomyopathy, dilated cardiomyopathy, or conduction abnormalities such as bundle branch and atrioventricular block. Patients usually present with HF symptoms. However, non-specific chest discomfort may be a presenting or coexisting feature. HCQ-induced cardiomyopathy is extremely rare and very difficult to diagnose because of non-specific presentation. Risk factors for development of HCQ-induced cardiotoxicity include old age, female sex, long duration of therapy (> 10 years), high dose HCQ, pre-existing cardiac disease and renal impairment. 1–5