| Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review. | |
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MedLine Citation:
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PMID: 19683138 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Trastuzumab (Herceptin) is well documented in reducing suffering and mortality from breast cancer. The clinically most important side effect of Herceptin is cardiotoxicity, which is reported in 2.6% to 4.5% of patients receiving trastuzumab alone and in as many as 27% of patients when trastuzumab is combined with an anthracycline in metastatic disease. We reported the case of a 50-year-old woman who presented to our emergency department (ED) because of chest pain and shortness of breath. On physical examination, holosystolic murmur over apex could be heard. Pulmonary and abdominal examinations were unremarkable. Twelve-lead electrocardiography showed sinus tachycardia and new onset of complete left bundle-branch block. Emergent transthoracic echocardiography revealed generalized hypokinesia of left ventricle and akinesia over interventricular septum and apex. She subsequently underwent immediate coronary angiography that revealed normal coronary angiography, and left ventriculogram revealed generalized hypokinesia with severe left ventricle dysfunction with ejection fraction of 33%. During right heart catheterization and endomyocardial biopsy, cardiac tamponade developed and was successfully relieved by pericardial window. She was discharged event-free 3 weeks later with conservative treatment. Although new onset of complete left bundle-branch block in a patient with chest pain may be acute coronary syndrome, careful review of medicine history is mandatory to avoid unnecessary procedure and complications. |
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Authors:
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Chung-Ming Tu; Kai-Ming Chu; Shin-Ping Yang; Shu-Mung Cheng; Wen-Been Wang |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 27 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-17 Completed Date: 2009-09-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 903.e1-3 Citation Subset: IM |
Affiliation:
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Division of Cardiology Department of Medicine, Song-Shan Armed Forces General Hospital, Taipei, Taiwan, R.O.C. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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diagnosis Antibodies, Monoclonal / adverse effects*, therapeutic use Antineoplastic Agents / adverse effects*, therapeutic use Breast Neoplasms / drug therapy, pathology Bundle-Branch Block / chemically induced, diagnosis* Carcinoma, Ductal, Breast / drug therapy, secondary Cardiomyopathies / chemically induced* Electrocardiography Female Heart / drug effects Humans Liver Neoplasms / drug therapy, secondary Middle Aged Ventricular Dysfunction, Left / chemically induced |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Antineoplastic Agents; 0/trastuzumab |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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