One Dose, One Wall: Isolated Septal Hypokinesia Triggered by First Doxorubicin Exposure

Area of Science:

• Oncology
• Cardiology
• Pharmacology

Background:

• Cardiotoxicity is a known adverse effect of anthracycline chemotherapy.
• Anthracycline-induced cardiotoxicity typically manifests after cumulative doses.
• Early onset cardiotoxicity after the first dose is rare but possible.

Purpose of the Study:

• To report a rare case of cardiotoxicity following the first dose of doxorubicin in a patient with acute lymphoblastic leukemia.
• To highlight the atypical presentation of anthracycline-induced cardiotoxicity.
• To raise awareness for early detection and prevention strategies.

Main Methods:

• Case report of a young male patient with acute lymphoblastic leukemia.
• Clinical presentation including dyspnea, chest pain, and edema.
• Diagnostic evaluation using transthoracic echocardiography.

Main Results:

• The patient developed cardiotoxicity after the first dose of doxorubicin.
• Echocardiography revealed a left ventricular ejection fraction of 40%, left ventricular dilation, and isolated septal hypokinesia.
• The patient's presentation was atypical, with normal lateral wall motion.

Conclusions:

• Cardiotoxicity can occur as early as the first dose of anthracycline therapy.
• Anthracycline-induced cardiotoxicity may present with unusual findings, such as isolated septal hypokinesia.
• Early recognition and monitoring for cardiotoxicity are crucial, even after initial doses.