Myocardial injury immediately following adriamycin administration

A patient is described who developed chest pain during adriamycin administration given for the first time for small cell carcinoma of the lung. This was associated with the acute onset of atrial fibrillation with a rapid ventricular response. Although no electrocardiographic changes of myocardial ischemia developed, serum isoenzyme studies suggested that myocardial injury had occurred. The patient recovered but died suddenly three weeks later. Physicians should be aware of possible life-threatening arrhythmias developing during or shortly after adriamycin administration.