Great Discussion at Morning Report today!

• Clozapine side effects include agranulocytosis, myocarditis, pulmonary embolism, seizures, excessive salivation, urinary incontinence, and constipation
• Clozapine mediated myocarditis is associated with eosinophilia and biopsy shows eosinophilic infiltrates consistent with an acute drug reaction.
• The time to onset of clozapine-induced myocarditis is 2-3 weeks after starting Clozapine
• Four stages of pericarditis on EKG
  • Stage 1: Widespread ST elevation and PR depression
  • Stage 2: Normalization of ST changes, new T wave flattening
  • Stage 3: Inversion of T waves
  • Stage 4: Normalized EKG or persistent T wave inversions
• Diagnosis of Acute Pericarditis requires at least 2/4 of the following must be present:
  • Typical chest pain
  • Pericardial Friction Rub
  • Suggestive EKG findings (typically widespread ST elevation)
  • New or worsening pericardial effusion
• Diagnosis of Myopericarditis:
  • Definite Diagnosis of Acute Pericarditis PLUS the following
  • Suggestive symptoms and EKG abnormalities beyond normal variants
  • Absence of other causes
  • Elevated cardiac enzymes, new onset depressed LV function, abnormal imaging