Reversible Cancer Therapeutics-related Cardiac Dysfunction Complicating Intra-cardiac Thrombi

Intern Med. 2020 Sep 1;59(17):2155-2160. doi: 10.2169/internalmedicine.4792-20. Epub 2020 Jun 2.

Abstract

Epirubicin-based chemotherapy carries a risk of inducing heart failure, although the frequency is rare. Bevacizumab, an anti-vascular endothelial growth factor monoclonal antibody, has recently been widely used in patients with recurrent breast cancer as a first-line chemotherapeutic agent. Heart failure or arterial thromboembolism has been reported as a rare cardiovascular complication of bevacizumab. We herein report a breast cancer patient with reversible cancer therapeutics-related cardiac dysfunction associated with bevacizumab and epirubicin complicating intracardiac thrombi in the left atrium and left ventricle. This case underscores the importance of tailored medical planning according to the individual status in patients receiving anti-cancer therapies.

Keywords: bevacizumab; cardiotoxicity; epirubicin; heart failure; thrombus.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use*
  • Bevacizumab / adverse effects*
  • Bevacizumab / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Epirubicin / adverse effects*
  • Epirubicin / therapeutic use
  • Female
  • Heart Failure / chemically induced*
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antineoplastic Agents
  • Bevacizumab
  • Epirubicin