TY - JOUR
T1 - Acute cardiomyopathy precipitated by lithium
T2 - Is there a direct toxic effect on cardiac myocytes?
AU - Anantha Narayanan, Mahesh
AU - Mahfood Haddad, Toufik
AU - Bansal, Ojas
AU - Baskaran, Janani
AU - Azzouz, Muhammad S.
AU - Akinapelli, Abhilash
AU - Esterbrooks, Dennis J.
N1 - Publisher Copyright:
© 2015 Published by Elsevier Inc.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Lithium is the drug of choice for bipolar disorder and has been in use for more than 50 years. Lithium is known to cause cardiac toxicity in humans including conduction disturbances, bradycardia, and repolarization abnormalities but has rarely been reported to cause left ventricular dysfunction. We report a patient with typical features of lithium toxicity including sinus bradycardia and junctional rhythm, who, in addition, presented atypical features with diffuse T-wave inversions, QT prolongation, and acute left ventricular systolic dysfunction with serum cardiac marker elevation. After excluding other causes of cardiomyopathy including coronary thrombosis, stress cardiomyopathy, and sepsis, a highly probable explanation for our patients acute left ventricular systolic dysfunction was lithiumtoxicity causing transient myocarditis. Extensive review of literature showed a fewcase reports of cardiac dysfunction associated with lithium, but acute left ventricular dysfunction caused by lithium has not been reported.
AB - Lithium is the drug of choice for bipolar disorder and has been in use for more than 50 years. Lithium is known to cause cardiac toxicity in humans including conduction disturbances, bradycardia, and repolarization abnormalities but has rarely been reported to cause left ventricular dysfunction. We report a patient with typical features of lithium toxicity including sinus bradycardia and junctional rhythm, who, in addition, presented atypical features with diffuse T-wave inversions, QT prolongation, and acute left ventricular systolic dysfunction with serum cardiac marker elevation. After excluding other causes of cardiomyopathy including coronary thrombosis, stress cardiomyopathy, and sepsis, a highly probable explanation for our patients acute left ventricular systolic dysfunction was lithiumtoxicity causing transient myocarditis. Extensive review of literature showed a fewcase reports of cardiac dysfunction associated with lithium, but acute left ventricular dysfunction caused by lithium has not been reported.
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U2 - 10.1016/j.ajem.2015.03.023
DO - 10.1016/j.ajem.2015.03.023
M3 - Article
C2 - 25997586
AN - SCOPUS:84940961339
SN - 0735-6757
VL - 33
SP - 1330.e1-1330.e5
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 9
ER -