Abstract
Abstract 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 can reveal early myocardial involvement and avoid further damage to the heart. Technological advances in imaging, such as the global longitudinal strain, and the increase in troponin I 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 (19 ng/mL) levels returned to normal. This is an example of the usefulness of new cardiooncology units that allow cancer patients to be evaluated, diagnosed and treated early in order to avoid cardiotoxicity and the resulting mortality.
Highlights
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
a 17-year-old female patient who was diagnosed with osteosarcoma in her left leg
This is an example of the usefulness of new cardio-oncology units that allow cancer patients to be evaluated
Summary
RESUMEN: La cardiotoxicidad es una entidad clínica relativamente nueva que, en caso de insuficiencia cardiaca, es un marcador de mal pronóstico en sobrevivientes de cáncer que han recibido, con mayor frecuencia, tratamiento con antraciclinas o trastuzumab. La detección de la disfunción cardiaca en estadio subclínico permite descubrir precozmente el compromiso miocárdico y evitar un mayor daño al corazón. Presentamos el caso de una paciente de 17 años diagnosticada de osteosarcoma en la pierna izquierda y que recibió antraciclinas. Este caso es un ejemplo de la utilidad de las nuevas unidades de cardio-oncología que permiten evaluar, diagnosticar y tratar precozmente a los pacientes oncológicos, para evitar la cardiotoxicidad y su respectiva mortalidad. Palabras clave: Cardio-oncología; Cardiotoxicidad; Antraciclinas; Trastuzumab; Deformación cardiaca; Troponina I (Fuente: DeCS BIREME)
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