A Case of Breast Cancer with Chemotherapy-Induced Arrhythmias and No Cardiac Dysfunction by Trastuzumab, a Highly Effective Anticancer Agent
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概要
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<B>Background:</B> Chemotherapy occasionally causes myocardial injury presenting ventricular tachyarrhythmias (VTs) due to its cardiotoxicity. Recently, chemotherapy-induced arrhythmias have been highlighted in clinical practice. We experienced a patient who suddenly had VTs without any cardiac dysfunction after chemotherapy for breast cancer.<BR><B>Case Presentation:</B> A 71-year-old woman was treated by trastuzumab, a highly effective anti-cancer agent as adjuvant for breast cancer. She had a history of atrial fibrillation, so that she underwent an echocardiography before administration of trastuzumab. We confirmed her cardiac function as normal and administered the agent. A 24-hour Holter electrocardiogram was performed during follow-up because she repeatedly complained faintness after sixth course of chemotherapy. Frequent non-sustained VTs were recorded. The incidence of VTs increased much more during daytime than at nighttime. Therefore, we started oral d-sotalol, class antiarrhythmic drug with a strong beta-adrenoreceptor blocking effect. VTs are promptly decreased after the administration of d-sotalol. Cardiac dysfunction remained absent after VTs. Consequently, trastuzumab was withdrawn to prevent the occurrence of VTs.<BR><B>Conclusion:</B> A large number of previous studies reported that the cardiotoxicity induced by chemotherapy involved myocardial injury with cardiac dysfunction, but the issue was not found in this patient. The cardiotoxicity of trastuzmab may vary in clinical situation.
著者
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Ikeda Takanori
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
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Miwa Yosuke
Second Department of Internal Medicine, Kyorin University School of Medicine
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Miwa Yosuke
Second Department Of Internal Medicine Kyorin University School Of Medicine
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Abe Atsuko
Second Department Of Internal Medicine Kyorin University School Of Medicine
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Yanagisawa Ryoji
Second Department Of Internal Medicine Kyorin University School Of Medicine
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Yoshino Hideaki
Second Department Of Internal Medicine Cardiology Kyorin University School Of Medicine
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