Paclitaxel-induced myocarditis presenting as new-onset heart failure

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Paclitaxel is a common chemotherapy agent used for various cancers.
• Myocarditis, inflammation of the heart muscle, is an uncommon side effect of chemotherapy.
• Systolic dysfunction, a condition where the heart's main pumping function is impaired, is not typically linked to paclitaxel.

Observation:

• A patient with uterine papillary serous carcinoma developed myocarditis with systolic dysfunction.
• The condition emerged after two cycles of carboplatin/paclitaxel chemotherapy.
• The patient had no pre-existing cardiac risk factors.

Findings:

• Cardiac MRI confirmed the diagnosis of myocarditis.
• The patient's condition was attributed to paclitaxel-induced cardiotoxicity.
• This case highlights a rare but serious adverse effect of paclitaxel.

Implications:

• Early recognition and diagnosis of paclitaxel-induced myocarditis are essential.
• Management involves addressing heart failure with reduced ejection fraction using guideline-directed medical therapy.
• Discontinuation of paclitaxel is a critical step in managing this adverse event.