Document Detail

Manageability of acute severe heart failure complicated with left ventricular thrombosis during therapy for breast cancer.
MedLine Citation:
PMID:  20379051     Owner:  NLM     Status:  MEDLINE    
Trastuzumab-related cardiac dysfunction may be manageable and completely reversible with suitable cardiac medication, allowing optimal breast cancer treatment to continue. We present the case of a 42-year-old woman who developed severe systolic left ventricular failure with impaired contractility of the right ventricle, pulmonary hypertension, and clots in the left ventricular cavity during adjuvant treatment for breast cancer. The patient was initially diagnosed with early breast cancer and underwent surgery on her left breast. She received 6 cycles of anthracycline chemotherapy followed by radiation therapy in the left breast area, then 5 cycles of trastuzumab. After the fifth cycle of trastuzumab, she experienced dyspnoea and leg edema. Fluid was detected in the pleural cavities but no lung metastases were identified. Echocardiography was performed, revealing a severely reduced left ventricular ejection fraction (10%) with impaired contractility of the right ventricle and pulmonary hypertension. Standard medication for heart failure resulted in complete recovery of normal systolic and diastolic function of the left and right ventricles. The combination of low molecular weight heparin and acetylsalicylic acid completely resolved the thrombotic complications. The patient regained her full range of social, occupational, and family activities. This case study is the first to demonstrate the manageability and reversibility of trastuzumab-related cardiac complications in a patient who had developed severe heart failure complicated with left ventricular thrombosis during sequential anthracycline and trastuzumab therapy for breast cancer. The findings contradict other opinions that trastuzumab-related acute heart failure is analogous to stunning or hibernation and recovers without specific cardiac treatment.
Sebastian Szmit; Marcin Kurzyna; Renata Glówczynska; Marcin Grabowski; Jaroslaw Kober; Justyna Czerniawska; Krzysztof J Filipiak; Grzegorz Opolski; Cezary Szczylik
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International heart journal     Volume:  51     ISSN:  1349-2365     ISO Abbreviation:  Int Heart J     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-09     Completed Date:  2010-05-18     Revised Date:  2013-05-08    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  141-5     Citation Subset:  IM    
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
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MeSH Terms
Anthracyclines / adverse effects
Antibodies, Monoclonal / adverse effects
Antibodies, Monoclonal, Humanized
Antineoplastic Agents / adverse effects
Breast Neoplasms / drug therapy*
Carcinoma, Lobular / drug therapy*
Heart Failure / chemically induced*,  diagnosis,  therapy*
Heart Ventricles
Thrombosis / chemically induced*,  diagnosis,  therapy*
Reg. No./Substance:
0/Anthracyclines; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antineoplastic Agents; P188ANX8CK/trastuzumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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