Images and Case Reports in Heart Failure Hydroxychloroquine - Induced Cardiomyopathy A

Case Presentation A 66-year-old white woman with a 24-year history of SLE presented to our institution with decompensated heart failure. She had no cardiac history until 8 weeks before admission, when she presented to an outside hospital for new-onset heart failure. Other significant medical history included gout, dyslipidemia, hypertension, and SLE first diagnosed in 1986 complicated by World Health Organization class 4 lupus nephritis, diagnosed in 2001. She was taking HCQ (400 mg daily), prednisone ( 5 mg/d), and azathioprine for treatment of SLE. The evaluation for new-onset heart failure at the outside facility consisted of an echocardiogram, which showed a left ventricular ejection fraction of 35% and coronary angiogram that revealed mild, nonobstructive coronary artery disease. The ECG showed new-onset, 3rd-degree atrioventricular block. She underwent placement of a biven-