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Updated: Jul 12, 2025

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
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Osimertinib-induced biventricular cardiomyopathy with abnormal cardiac MRI findings: a case report

Karishma Patel1, Kristie Y Hsu1, Kevin Lou1

  • 1Department of Medicine, University of California, San Francisco, CA, USA.

Cardio-Oncology (London, England)
|November 1, 2023
PubMed
Abstract

Insights

Osimertinib, an EGFR inhibitor for non-small cell lung cancer, can cause heart failure. This case shows cardiac MRI findings and successful treatment by managing heart failure and switching medication.

Area of Science:

  • Cardiology
  • Oncology
  • Radiology

Background:

  • Osimertinib is a first-line treatment for EGFR-mutated non-small cell lung cancer (NSCLC).
  • While effective, osimertinib can cause serious cardiovascular adverse effects.
  • Understanding these toxicities is crucial for patient management.

Purpose of the Study:

  • To report a case of osimertinib-induced non-ischemic cardiomyopathy.
  • To describe novel cardiac MRI findings in osimertinib-associated cardiotoxicity.
  • To highlight management strategies for severe cardiac toxicities in cancer patients.

Main Methods:

  • Case presentation of a 63-year-old man with EGFR-mutated NSCLC treated with osimertinib.
  • Cardiac MRI was used to identify myocardial edema and late gadolinium enhancement.
  • Treatment involved medical therapy for heart failure and switching to afatinib.

Main Results:

  • The patient developed new-onset non-ischemic cardiomyopathy with biventricular dysfunction and heart failure.
  • Cardiac MRI revealed focal late gadolinium enhancement and myocardial edema.
  • Biventricular function normalized after heart failure treatment and medication change.

Conclusions:

  • Osimertinib can induce significant cardiotoxicity, including cardiomyopathy.
  • Cardiac MRI is valuable for diagnosing osimertinib-associated cardiac issues.
  • Multidisciplinary care is essential for managing cardiotoxicity and optimizing oncologic outcomes.
Keywords:
Cardio-oncologyCardiomyopathyOsimertinibPericardial effusionTamponade

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