Cardiotoxic effects of chemotherapeutical treatment in oncological patient

The aim of study was to describe the clinical case of possible development of cardiac complications in patient after the chemotherapeutical treatment.

Materials and methods. Patient Sh., 63 years old, admitted to N.I. Pirogov City Clinical Hospital № 1 of Moscow Healthcare Department in connection with new onset of anginalprecordialgia. In anamnesis: rectum adenocarcinoma with multiple courses of chemotherapy of first and second lines. The last course of chemotherapy was performed a month before the previous complaints. Previously, coronary anamnesis was not burdened.

Results. During the examination, signs of ischemia on the electrocardiogram, diffuse hypokinesia of the left ventricular myocardium according to echocardiography, subocclusion of the anterior interventricular branch of the left coronary artery were identified. Balloon angioplasty and stenting of the anterior interventricular branch of the left coronary artery were performed with good perfusion effect.

Conclusion. In this clinical case, ischemic complications in patient receiving chemotherapeutical treatment are displayed.

1. Ferlay J., Steliarova‑Foucher E., Lortet‑ Tieulent J. et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 2013;49(6):1374–403. DOI: 10.1016/j.ejca.2012.12.027. PMID: 23485231.

2. Ewer M. S., Ewer S. M. Cardiotoxicity of anticancer treatments. Nat Rev Cardiol 2015;12(11):620. DOI: 10.1038/nrcardio.2015.133. PMID: 26292190.

3. Zamorano J. L., Lancellotti P., Rodriguez Munoz D. et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur J Heart Fail 2017;19(1):9–42. DOI: 10.1002/ejhf.654. PMID: 27565769.

4. Moore R. A., Adel N., Riedel E. et al. High incidence of thromboembolic events in patients treated with cisplatin‑based chemotherapy: a large retrospective analysis. J Clin Oncol 2011;29(25):3466–73. DOI: 10.1200/JCO.2011.35.5669. PMID: 21810688.

5. Haugnes H. S., Wethal T., Aass N. et al. Cardiovascular risk factors and morbidity in long‑term survivors of testicular cancer: a 20‑year follow‑up study. J Clin Oncol 2010;28:4649–57. DOI: 10.1200/JCO.2010.29.9362. PMID: 20855830.

6. Ito D., Shiraishi J., Nakamura T. et al. Primary percutaneous coronary intervention and intravascular ultrasound imaging for coronary thrombosis after cisplatin‑based chemotherapy. Heart Vessels 2012;27(6):634–8. DOI: 10.1007/s00380‑011‑0222‑5. PMID: 22218740.

7. Ozben B., Kurt R., Oflaz H. et al. Acute anterior myocardial infarction after chemotherapy for testicular seminoma in a young patient. Clin Appl Thromb Hemost 2007;13(4):439 –42. DOI: 10.1177/1076029607303334. PMID: 17911198.

8. Kapelakis I., Toutouzas K., Drakopoulou M. et al. Bevacizumab increases the incidence of cardiovascular events in patients with metastatic breast or colorectal cancer. Hellenic J Cardiol 2017;58(3):215–9. DOI: 10.1016/j.hjc.2016.11.022. PMID: 28258825.