Intermittent left bundle branch block and acute heart failure in trastuzumab-induced cardiotoxicity.

MedStar author(s):
Citation: BMJ Case Reports. 13(7), 2020 Jul 28.PMID: 32723779Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Antineoplastic Agents, Immunological/ae [Adverse Effects] | *Bundle-Branch Block/ci [Chemically Induced] | *Heart Failure, Systolic/ci [Chemically Induced] | *Trastuzumab/ae [Adverse Effects] | Aged | Breast Neoplasms/ch [Chemistry] | Breast Neoplasms/dt [Drug Therapy] | Bundle-Branch Block/pp [Physiopathology] | Cardiotoxicity/co [Complications] | Electrocardiography | Female | HumansYear: 2020ISSN:
  • 1757-790X
Name of journal: BMJ case reportsAbstract: A 70-year-old woman with HER2+/ER+ breast cancer on adjuvant trastuzumab therapy without a history of cardiovascular disease presented with respiratory failure from influenza and was found to have intermittent left bundle branch block (LBBB) with new onset systolic heart failure. Her course was complicated by polymorphic ventricular tachycardia and recurrent chest pain. Significant investigations included a normal cardiac MRI and cardiac catheterisation with unobstructed coronaries. It was determined that the aetiology of her heart failure was trastuzumab-induced cardiotoxicity after comprehensive workup. This case highlights an uncommon presentation of LBBB and the steps taken to diagnose a rare cardiomyopathy. Copyright (c) BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.All authors: Bakhshi H, Haddad TM, Masson ROriginally published: BMJ Case Reports. 13(7), 2020 Jul 28.Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2020-09-02
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Journal Article MedStar Authors Catalog Article 32723779 Available 32723779

A 70-year-old woman with HER2+/ER+ breast cancer on adjuvant trastuzumab therapy without a history of cardiovascular disease presented with respiratory failure from influenza and was found to have intermittent left bundle branch block (LBBB) with new onset systolic heart failure. Her course was complicated by polymorphic ventricular tachycardia and recurrent chest pain. Significant investigations included a normal cardiac MRI and cardiac catheterisation with unobstructed coronaries. It was determined that the aetiology of her heart failure was trastuzumab-induced cardiotoxicity after comprehensive workup. This case highlights an uncommon presentation of LBBB and the steps taken to diagnose a rare cardiomyopathy. Copyright (c) BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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