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SLE/RA + new cardiomyopathy , add chronic hydroxychloroquine usage to the DDx! The DDx of cardiomyopathy in these autoimmune conditions more commonly invokes myocarditis, amyloid, related CAD, & other chronic Rx – @CPSolvers https://twitter.com/HFpEF/status/1335727510944952321
SLE/RA + new cardiomyopathy , add chronic hydroxychloroquine usage to the DDx! The DDx of cardiomyopathy in these autoimmune conditions more commonly invokes myocarditis, amyloid, related CAD, & other chronic Rx – @CPSolvers https://twitter.com/HFpEF/status/1335727510944952321
Another great takeaway in @HFpEF's own words: "Use the clinical info and 2D echo to help guide assessment of diastology. And don't be afraid to perform endomyocardial biopsy in HFpEF patients." I've been on 2 cardiology rotations & never once considered this!
Regarding biopsy: "The path findings in HCQ cardiotoxicity were first reported by Piette et al. & include enlarged/vacuolated cells on light microscopy, and the presence of myelinoid and curvilinear bodies – thought to represent abnormal lysosomes" https://journals.sagepub.com/doi/full/10.1177/2048872612471215
From the above reference: "Diffusely thickened ventricular walls on transthoracic echocardiography are one of the hallmarks of this form of cardiomyopathy. Biatrial enlargement & restrictive physiology are frequently associated."
@HFpEF, thank you for the fantastic thread. (Also, I love your handle!)
