Cessation of the culprit drug, along with aggressive afterload reduction therapy, has been associated with halting of disease progress and even improvement in patients' clinical and histologic status. (B) Doppler tissue imaging of lateral mitral annulus documents Ea 7.2cm/s and Aa velocity 2.7cm/s. (C) Pulsed Doppler of mitral inflow demonstrates left ventricular restrictive physiology. At presentation (left) electron micrograph (magnification ×11000) shows central replacement and displacement of sarcomeres by marked accumulation of secondary lysosomes including myeloid bodies (MB) and curvilinear bodies (CL). Echocardiography is a fundamental tool in the identification and assessment of patients with cardiomyopathy, with particular utility in the detailed assessment of biventricular systolic and diastolic function. This appearance is typical and characteristic of chloroquine and hydroxychloroquine toxicity. What does the drug plaquenil do Plaquenil eyewiki The diagnosis of HCQ-induced myopathy was made with electromyography and muscle biopsy. HCQ was discontinued, with improvement of the patient's signs Hydroxychloroquine myopathy. DISCUSSION Hydroxychloroquine HCQ, a commonly used drug for various autoimmune conditions, is widely distributed into cardiac and skeletal muscle tissue. Chloroquine CQ and hydroxychloroquine HCQ are anti‐rheumatic medications frequently used in the treatment of connective tissue disorders. We present the case of a 45‐year‐old woman with CQ‐induced cardiomyopathy leading to severe heart failure. We present a case of a 51-year-old woman with hydroxychloroquine-induced restrictive cardiomyopathy and correlate clinical, echocardiographic and anatomic pathologic findings both at initial presentation and following treatment. Electron micrograph (magnification ×6700) shows normal myocyte ultrastructure with secondary lysosomes that would appear by light microscopy as lipofuscin pigment. Difference between A duration (tricuspid) and A duration (hepatic vein flow)=70ms." path-from-xml="8-4-247-fig3.jpeg" /Echocardiographic findings at 2 years. It also provides an objective and non-invasive means of assessing treatment response. (F) Pulsed Doppler of hepatic vein flow shows blunting of systolic flow with prominent atrial flow reversals in both inspiration and expiration. At 2 years (right) myocardial biopsy shows near complete resolution of electron microscopic findings of hydroxychloroquine toxicity. (D) Pulsed Doppler of pulmonary vein flow shows normal forward flow characteristics (systolic velocitydiastolic velocity) but with persisting prominent atrial flow reversals in both inspiration and expiration. Plaquenil myopathy Plaquenil Side Effects Common, Severe, Long Term -, Final Diagnosis -- Hydroxychloroquine myopathy - Sigma chemical chloroquine phosphate Diagnosis of Drug-induced Myopathies. A drug-induced, or toxic, myopathy is defined as the acute or subacute manifestation of myopathic symptoms such as muscle weakness, myalgia, creatine kinase CK elevation, or myoglobinuria that can occur in patients without muscle disease when they are exposed to certain drugs 1. Drug-related Myopathies of Which the Clinician Should Be Aware. Chloroquine‐induced cardiomyopathy a reversible cause of.. Hydroxychloroquine and Colchicine Induced Myopathy The.. Postmarketing cases of life-threatening and fatal cardiomyopathy have been reported with use of Plaquenil and chloroquine. Patients may present with atrioventricular AV block, pulmonary hypertension, sick sinus syndrome or with cardiac complications. ECG findings may include AV, right or left bundle branch block. Hydroxychloroquine HCQ is a 4-aminoquinoline which differs from chloroquine CQ in the addition of a hydroxyl group. Initially used as antimalarials, both drugs have now become mainstays in the management of rheumatic diseases principally systemic lupus erythematosus SLE and rheumatoid arthritis RA. Plaquenil and Cardiomyopathy - a study from real-world data. Summary Cardiomyopathy is found among people who take Plaquenil, especially for people who are female, 60+ old, have been taking the drug for 10+ years, also take medication Lasix, and have Multiple myeloma.