Drug-induced heart failure

Heart failure is a clinical syndrome that is predominantly caused by cardio vascular disorders such as coronary heart disease and hypertension. However , several classes of drugs may induce heart failure in patients without con current cardiovascular disease or may precipitate the occurrence of heart f ailure in patients with preexisting left ventricular impairment. We reviewe d the literature on drug-induced heart failure, using the MEDLINE database and lateral references. Successively, we discuss the potential role in the occurrence of heart failure of cytostatics, immunomodulating drugs, antidep ressants, calcium channel blocking agents, nonsteroidal anti-inflammatory d rugs, antiarrhythmics, beta-adrenoceptor blocking agents, anesthetics and s ome miscellaneous agents. Drug-induced heart failure may play a role in onl y a minority of the patients presenting with heart failure. Nevertheless, d rug-induced heart failure should be regarded as a potentially preventable c ause of heart failure, although sometimes other priorities do not offer the rapeutic alternatives (e.g., anthracycline-induced cardiomyopathy). The awa reness of clinicians of potential adverse effects on cardiac performance by several classes of drugs, particularly in patients with preexisting ventri cular dysfunction, may contribute to timely diagnosis and prevention of dru g-induced heart failure. (C) 1999 by the American College of Cardiology.