CHEST PAIN AS INITIAL CARDIOVASCULAR SIDE EFFECT OF ESCITALOPRAM: LITERATURE UPDATE ON MANAGEMENT PROTOCOL
Ogochukwu Agazie* MD MPH, Nnenna Bessie Emejuru MD, Gideon Onyebuchi Idoko MBBS MHM, Graduate Certificate in Healthcare Administration, Joy Ugwuanyi MBBS, Samuel Alao MD MPH, Vivien Obitulata-Ugwu MD, Afolarin Ishola MBBS MPH, Sybille Defeugaing MD, Ted Olivier Monte MD, Francis Ojochem Oyih MD, Chinenye Loveth Alek BPT, Ndukaku Ogbonna MD MS, Evaristus Chino Ezema MD MSc Dr. HA.
ABSTRACT
Background: Escitalopram is a highly selective serotonin reuptake inhibitor commonly used for the treatment of major depressive disorder and generalized anxiety disorder. In addition to the common sexual side effect. There are varying reports of its cardiovascular side effects. It is therefore imperative that a simple complaint of chest pain in a patient on escitalopram should attract a comprehensive evaluation. Methods: We employed a structured narrative approach to identify and review available articles on escitalopram and cardiovascular side effects. We aimed to evaluate the association between escitalopram therapy and adverse cardiovascular side effects. Results: We identified no direct chest pain reports during escitalopram therapy. There are documented reports of rare side effects with potential chest pain manifestation. These are QT prolongation and arrhythmias, including torsades de pointes. Others reported a safe cardiovascular profile of escitalopram. Conclusions: Despite its good therapeutic potential, there are nuanced reports of escitalopram’s rare cardiovascular effects. Chest pain should be part of the regular evaluation of patients on escitalopram. Health education should be given to immediately call for help when the pain is sudden, severe, chest pain lasts longer than a few minutes, or is accompanied by symptoms like crushing pressure, pain radiating to the arm or jaw, shortness of breath, or nausea according to the American Heart Association guidelines.
Keywords: cardiovascular, chest, escitalopram, effect, pain, side.
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