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Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

1
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
1
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

1
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

1
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
1
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

1
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
1

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Delayed Trastuzumab-induced Cardiotoxicity Leading to Severe Left Ventricular Dysfunction.

Ikuo Misumi1, Reiki Nishimura2, Shota Nakamura3

  • 1Department of Cardiology, Ueki Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|October 20, 2024
PubMed
Summary

This case study highlights delayed trastuzumab-induced myocardial injury in an elderly woman. Serial cardiac imaging revealed significant improvement in heart function after treatment cessation.

Keywords:
cardiac magnetic resonancedelayed trastuzumab-induced cardiotoxicityseptal injury

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Area of Science:

  • Cardiology
  • Oncology
  • Medical Imaging

Background:

  • Trastuzumab is a targeted therapy used in cancer treatment.
  • Cardiotoxicity is a known side effect of trastuzumab, often appearing early in treatment.
  • Delayed-onset cardiotoxicity is less common but requires vigilant monitoring.

Purpose of the Study:

  • To present a case of delayed trastuzumab-induced myocardial injury.
  • To illustrate the utility of serial cardiac imaging in evaluating cardiac function and structure.
  • To emphasize the importance of long-term cardiac monitoring in patients treated with trastuzumab.

Main Methods:

  • A case report of an 81-year-old woman with dyspnea after nine years of trastuzumab therapy.
  • Diagnostic imaging included chest radiography, transthoracic echocardiography, and cardiac magnetic resonance imaging (CMR).
  • Serial echocardiography was performed to monitor left ventricular ejection fraction (LVEF) over time.

Main Results:

  • Chest radiography showed pleural effusion.
  • Transthoracic echocardiography revealed interventricular septum (IVS) dyskinesis.
  • CMR indicated myocardial edema or fibrosis in the interventricular septum and apex.
  • LVEF improved from 25% to 48% over six months following initial assessment.

Conclusions:

  • Delayed trastuzumab-induced myocardial injury can occur years after treatment initiation.
  • Serial transthoracic echocardiography and CMR are valuable tools for assessing cardiac structure and function in such cases.
  • Long-term cardiac surveillance is crucial for patients receiving trastuzumab therapy.