To a Problem of a Neuroleptic Cardiomyopathy: Brief Review of a Literature and of Own Researches

Abstract

Introduction: Neuroleptic cardiomyopathy (NCMP) belongs to secondary specific metabolic dilated cardiomyopathies. It is caused by side cardiotoxic effect of antipsychotic drugs. Many aspects of epidemiology, pathogenesis, morphology, clinical picture and diagnostics of NCMP still remain insufficiently explored.

Results: NCMP passes through 3 stages in its development: 1) a latent one, 2) a full-scale one, and 3) a terminal one. Each stage has clinical features, electrocardiograph signs and certain morphology.

Lethal termination in a latent and in a full-scale stage either takes place because of intercurrent diseases or it is a sudden cardiac death of arrythmogenic genesis. In the terminal stage, the direct cause of death is, as a rule, a progressive congestive chronic cardiac failure.

On the macroscopic level, NCMP is characterized by a moderate cardiomegaly; by a noticeable dilatation of heart ventricles; by absence of evident coronary atherosclerosis.

On the microscopic level, all structural components of myocardium (microvasculature, intercellular matrix, cardiomyocytes) are deeply damaged. These pathologic changes are a physical basis of a contractile myocardial dysfunction.

Conclusion: On the basis of the summarizing of the data, which were received in a series of studies, we singled out and proved clinical and morphological criteria of diagnostics of NCMP.

Taking the described clinical and morphologic peculiarities of NCMP into account, it is advisable and quite logic to single-out this pathology into an independent nosologic unit.