„Iron Heart”: Reversible Cause of Dilated Cardiomyopathy Secondary to Cardiac Toxicity in Elderly Patient with Myelodysplastic Syndrome

Abstract

The most common non-hematological cause of death in patients with low-risk myelodysplastic syndrome (MDS) who receive chronic supportive transfusion therapy (STT) through red blood cells (RBC) is known to be related to cardiac events, especially, cardiac siderosis [1].At the time patients develop symptoms secondary to cardiac toxicity, the disease reaches an advanced phase with a very high mortality rate. However, we report the case of an old female patient with severe acute heart failure (HF) and signs of elevated myocardial iron deposits by cardiac magnetic resonance, who experienced an unexpected and marked clinical improvement using a combination of intensive iron chelation therapy (ICT) and specific treatment for HF. She overcame the HF acute phase, recovered her systolic function and remained stable at mid-term of follow-up (18 months).