A number of drugs and chemicals can cause toxic myocarditis.
Causes of a toxic myocarditis:
(1) stimulants (amphetamines, cocaine, catecholamines, pheochromocytoma, thyrotoxicosis)
(2) anthracyclines
(3) cyclophosphamide
(4) 5-fluorouracil (5-FU)
(5) trastuzumab (Herceptin)
(6) clozapine
(7) ethanol
(8) lithium
(9) heavy metals (copper, iron, lead)
(10) venom or stings (scorpion, snake, spider, bee sting, wasp sting)
(11) carbon monoxide
(12) phosphorus
(13) arsenic
(14) sodium azide
(15) volatile inhalants
(16) interleukin-2 (cytokines)
Differential diagnosis:
(1) immune-mediated myocarditis associated with drug allergy
(2) other forms of myocarditis