Favourable outcome in a primigravida with hydroxychloroquine (HCQ) induced (most likely) cardiomyopathy: a case report and literature review

Background. Hydroxychloroquine-induced cardiomyopathy occurs due to prolonged therapy with hydroxychloroquine (HCQ). For favourable outcome prompt diagnosis, immediate discontinuation of HCQ, and use of suitable alternatives is necessary for comprehensive management. Case presentation. Here we report a case of cardiomyopathy most likely due to prolonged HCQ therapy in a 29-years-old primigravida with well-controlled discoid lupus and hypertension and no other known cardiac illness. The patient was successfully managed with standard drugs used for heart failure. She was treated by a multidisciplinary team involving obstetricians and cardiologists. Repeat echocardiogram and ultrasonography was used to assess the wellbeing of mother and foetus. Elective caesarean section at 34 weeks of gestation was opted by the team. Conclusions. Both the mother and baby had favourable outcomes and discharged on 3^rd postoperative day. Follow up after two weeks revealed well compensated cardiac status.