Androgen deprivation therapy mimicking acute coronary syndrome: A case report

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Androgen deprivation therapy (ADT) is a cornerstone treatment for advanced prostate cancer.
• Cardiac side effects, though uncommon, are a potential concern with ADT.
• Electrocardiogram (ECG) abnormalities, including QT interval prolongation, have been rarely reported.

Observation:

• An 80-year-old male on ADT presented with chest pain and ECG changes suggestive of acute coronary syndrome (ACS).
• Initial cardiac workup, including biomarkers and coronary angiography, was negative for ACS.
• Other potential causes like electrolyte imbalance and structural heart disease were ruled out.

Findings:

• Repolarization abnormalities and QT interval prolongation on ECG were observed.
• These cardiac changes resolved after discontinuation of the androgen deprivation therapy.
• The clinical presentation strongly suggested a drug-induced cardiac event.

Implications:

• ADT should be considered as a potential cause of QT interval prolongation and chest pain in prostate cancer patients.
• This case underscores the importance of a thorough medication review in patients presenting with cardiac symptoms.
• Awareness of rare drug side effects can prevent misdiagnosis and unnecessary invasive procedures.