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

• Published in: Internal Medicine Vol. 59; no. 17; pp. 2155 - 2160
• Main Authors: Tsujinaga, Shingo, Iwano, Hiroyuki, Oshino, Tomohiro, Kadosaka, Takahide, Mizuguchi, Yoshifumi, Motoi, Ko, Chiba, Yasuyuki, Koya, Taro, Temma, Taro, Kamiya, Kiwamu, Fukushima, Arata, Koizumi, Takuya, Sato, Tomoya, Takenaka, Sakae, Tada, Atsushi, Ishizaka, Suguru, Sarashina, Miwa, Omote, Kazunori, Kamada, Rui, Konishi, Takao, Sato, Takuma, Nagai, Toshiyuki, Yamashita, Hiroko, Anzai, Toshihisa
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.09.2020; Japan Science and Technology Agency
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Aged; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Atrium; Bevacizumab; Bevacizumab - adverse effects; Bevacizumab - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; cardiotoxicity; Case Report; Chemotherapy; Congestive heart failure; Epirubicin; Epirubicin - adverse effects; Epirubicin - therapeutic use; Female; Heart failure; Heart Failure - chemically induced; Heart Failure - drug therapy; Heart Failure - physiopathology; Humans; Internal medicine; Monoclonal antibodies; Targeted cancer therapy; Thromboembolism; thrombus; Treatment Outcome; Vascular endothelial growth factor; Ventricle; bevacizumab; heart failure; epirubicin; cardiotoxicity; thrombus
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.4792-20

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.