Coroner's Finding: LARIZZA Giuseppe

79y · Male·ischaemic heart disease

A 79-year-old man with a history of myocardial infarctions, coronary artery bypass graft, schizophrenia, and ischaemic heart disease died of acute cardiac failure while detained in a mental health facility. He had been appropriately assessed by cardiology before commencing clozapine therapy in May 2012, with echocardiography on the day of death showing normal cardiac function. Post-mortem examination confirmed ischaemic heart disease as the cause and found no evidence of clozapine-related cardiomyopathy. The clinical lesson is that in patients with complex psychiatric and cardiac histories, careful multidisciplinary assessment and ongoing cardiac monitoring during antipsychotic therapy can appropriately manage risk. The coroner found care and supervision were maintained at a proficient level and made no recommendations.