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Horizonte Médico (Lima)

Print version ISSN 1727-558X


RUIZ-MORI, Enrique et al. Subclinical cardiac dysfunction in cancer patients: a case report. Horiz. Med. [online]. 2020, vol.20, n.1, pp.88-96. ISSN 1727-558X.

Cardiotoxicity is a relatively new clinical entity which, in the case of heart failure, is a marker of poor prognosis in cancer survivors who have received more frequent treatments with anthracyclines or trastuzumab. In these patients, detecting a cardiac dysfunction in the subclinical stage allows revealing early myocardial involvement and avoiding further damage to the heart. The increase in troponin I and the technological advances in imaging, such as the global longitudinal strain, enable the detection of this condition. This case report involves a 17-year-old female patient who was diagnosed with osteosarcoma in her left leg and received anthracyclines. In the cardiovascular evaluation, she was asymptomatic, and showed normal left ventricular function (60 %), decreased strain rate (-15 %) and elevated troponin I levels (115 ng/mL). Asymptomatic cardiac dysfunction was diagnosed and carvedilol 6.25 mg/day was prescribed. After 3 months of treatment, the strain rate (-20 %) and troponin I levels (19 ng/mL) returned to normal. This is an example of the usefulness of new cardio-oncology units that allow cancer patients to be evaluated, diagnosed and treated early in order to avoid cardiotoxicity and the resulting mortality.

Keywords : Cardio-oncology; Cardiotoxicity; Anthracyclines; Trastuzumab; Cardiac strain; Troponin I.

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