A Case of Takotsubo Cardiomyopathy during Trastuzumab Containing Chemotherapy for Recurrent Breast Cancer

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  • HASEGAWA Satoshi
    Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital
  • HARADA Fumi
    Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital
  • OTA Youhei
    Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital
  • FUKUSHIMA Tadao
    Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital
  • TOMARI Sakie
    Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital
  • IKE Hideyuki
    Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital

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  • 再発乳癌に対するトラスツズマブ投与中に発症したたこつぼ型心筋症の1例
  • 症例 再発乳癌に対するトラスツズマブ投与中に発症したたこつぼ型心筋症の1例
  • ショウレイ サイハツ ニュウガン ニ タイスル トラスツズマブ トウヨ チュウ ニ ハッショウ シ タタ コツボカタ シンキンショウ ノ 1レイ

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Abstract

A 67-year-old woman with recurrent breast cancer and multiple lung and bone metastases developed shortness of breath and palpitations while receiving combination chemotherapy with trastuzumab combined with gemcitabine. Her electrocardiogram showed T-wave inversion from a flat T in V1-3, and T-wave inversion and ST-segment elevation in V3-6. Echocardiography demonstrated severe left ventricular apical hypokinesia. The ejection fraction (EF) was 47%. Coronary angiography showed normal coronary arteries, and left ventriculography demonstrated severe, extensive, apical hypokinesia. Takotsubo cardiomyopathy was diagnosed. The patient was treated with human atrial natriuretic peptide (hANP), heparin, and furosemide, and left ventricular function evaluated with echocardiography improved gradually. EF was 66.6% on the 19th day of hANP treatment. She was discharged from the hospital on the 26th day. Reports of Takotsubo cardiomyopathy during chemotherapy are rare. Anti-cancer agents such as anti-HER2 drugs and anthracyclines are often administered for breast cancer treatment, and stress cardiomyopathy must also be considered in the differential diagnosis.

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