Shunt reversal due to deterioration of chloroquine-induced cardiomyopathy in a patient with primary Sjögren syndrome

Antimalarial-induced cardiomyopathy: a systematic review of the literature

“…Concerning heart specific biomarkers, cardiac troponin was reported abnormal in eight patients 26,27,37,39,43,44,48,49 and normal in one; 30 interestingly, one patient had intermittently abnormal troponin for two years before diagnosis. 44 Brain natriuretic peptide (BNP) was found to be abnormal in all 10 cases where it was reported.…”

“…Elevated right ventricular systolic pressure (RVSP) was reported in four cases and ranged between 40 and 50 mmHg. 25,30,37,41,48 Restrictive filling pattern of the left ventricle was documented in 18 patients (51.4%). Of note, one patient had normal echocardiographic findings.…”

“…44 Brain natriuretic peptide (BNP) was found to be abnormal in all 10 cases where it was reported. 25,30,37,41,43,44,48–50…”

“…Conduction abnormalities were the most common finding with complete atrioventricular block (AVB) being reported in 17 cases (48.6%). 11–13,15,16,20,22,23,25,33,36,37,39,41,43,47,48 One patient had a second-degree AVB 30 and two patients first-degree AVB. 19,26 Sick sinus syndrome was diagnosed in three patients, 27,34,43 right bundle branch block (BBB) in nine 17,19–21,26,27,29,30,39 and left BBB in five patients.…”

“…19,26 Sick sinus syndrome was diagnosed in three patients, 27,34,43 right bundle branch block (BBB) in nine 17,19–21,26,27,29,30,39 and left BBB in five patients. 17,19,38,44,49 Interestingly, 24 patients (51%) received a permanent pacemaker, 11–13,16,17,19,20,23–25,27,28,30,33–37,39,41,43,47,48 some of them up to four years before AMIC diagnosis. 16,23,25,47,48…”