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All Journal Heart Science Journal JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH
Rahmi, Koyuki Atifa
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Journal : Heart Science Journal

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Cardiovascular side effects and toxicity of lithium usage in adults: A systematic review of case reports and observational studies Rahmi, Koyuki Atifa; Khotimah, Husnul; Rohman, Mohammad Saifur
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.7

Abstract

BACKGROUND: Lithium is a first-line treatment for Bipolar Affective Disorder, but it has a narrow therapeutic range and has been shown to have cardiovascular side effects. This study aimed to compile the cases of lithium-induced cardiovascular abnormalities and the pathological mechanisms behind those effects. OBJECTIVES: To conduct a systematic review of case reports in adult patients who experienced cardiovascular side effects of lithium in the last 11 years. METHODS: The PRISMA method was followed to search PubMed, Wiley Online Library, ResearchGate, Springer, Semantic Scholar, and Google Scholar databases for articles from January 2013 to June 2024 using combinations of 'lithium,' 'cardiac,' 'cardiovascular,' 'side effect,' 'patient,' and 'case.' Case reports and observational studies concerning lithium use were identified for cardiovascular side effects. RESULTS: Reported cardiovascular side effects of lithium included ECG abnormalities (N=31), myocarditis (N=1), cardiomyopathies (N=4), cardiac tamponade (N=1), thrombosis (N=1), and pulmonary hypertension (N=1). Lithium causes cardiovascular abnormalities via sodium channel blockage, interference with cardiac pacemaker cells, increased serum catecholamines and serotonin, disruption of thyroid gland functions, and induction of nephrogenic diabetes insipidus, leading to hemodynamic imbalance. CONCLUSION: Lithium precipitates cardiac side effects and toxicity through direct interference with the cardiac conduction system, disruption of metabolic hormones, and multi-organ interactions.
Co-Authors Budiono, Perthdyatama Syifaq Diani, Masyithoh Wahyu En, Theophilus Tan Zhu Fatihuddin, Mohammad Fata Gunawan, Ayu Liana Husnul Khotimah Khoirunnisa, Auliai Linda Dewanti Moediarso, Bisyamsi Nawaijaya Mogi, Anjelina Kristina Mohammad Saifur Rohman Nuswantoro, Djohar Purwati, Cincin Hari Rantam, Berli Arfani Rarasati, Birgitta Vania