A Rational Approach to the Clinical Diagnostics of Neuroleptic Cardiomyopathy

Introduction: The presented review is devoted to generalization of results of own researches of the author on a problem of almost not studied pathology – a neuroleptic (antipsychotic) cardiomyopathy (NCMP).

NCMP belongs to secondary specific metabolic dilated cardiomyopathies. It is caused by side cardiotoxic effect of antipsychotic preparations. Many parties of epidemiology, pathogenesis, morphology, clinic and diagnostics of NCMP remain still insufficiently developed.

Results: As showed our researches the development of NCMP passes 3 stages: 1) latent, 2) developed and 3) terminal. Each stage has the clinical features, electrocardiograph signs and certain morphology.
The lethal outcome in latent and in developed stages either comes from the intercurrent diseases or is the sudden cardiac death of arhythmogenic genesis. The progressing congestive heart failure serves in a terminal stage as an immediate cause of death.
Apparently from our researches morphologically NCMP is characterized by a moderate hypertrophy of heart, expansion of its ventricles and absence of the expressed coronary atherosclerosis.

At microscopic research of a myocardium at early stages microcirculation violations come to light. Damages of an extracellular matrix (interstitial oedema and myofibrosis) develop then. Dystrophic-degenerative and atrophic changes of cardiomocytes act into the forefront in a terminal stage. It leads to contractile myocardial dysfunction.

Conclusion: On the basis of synthesis of the data obtained in a number of the own researches clinical and morphological criteria of diagnostics of NCMP are allocated and proved. Considering the described features of NCMP the given pathology is allocated in separate independent nosological unit expediently and quite logical.

Keywords: antipsychotics, cardiotoxicity, clinic, diagnostics, morphology, neuroleptic cardiomyopathy, nosological independence.