The Effective Use of Digoxin in a Patient with Metastatic Breast Cancer and Anthracycline-induced Cardiomyopathy

Anthracyclines have cardiotoxic side effects. Cardioprotective drugs such as angiotensin-converting enzyme inhibitors and beta-blockers are therefore recommended for patients with anthracycline-induced cardiomyopathy. We herein present a 54-year-old woman with recurrent metastatic breast cancer who...

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Bibliographic Details
Published in:Internal Medicine 2021/09/01, Vol.60(17), pp.2819-2823
Main Authors: Shiga, Tsuyoshi, Im, Jihaeng, Kikuchi, Noriko, Arakawa, Yasuhiro
Format: Article
Language:English
Subjects:
Angiotensin
Angiotensin-converting enzyme inhibitors
Anthracycline
Anthracyclines - adverse effects
Arrhythmia
Breast cancer
Breast Neoplasms - drug therapy
Cardiomyopathies - chemically induced
Cardiomyopathies - diagnosis
Cardiomyopathies - drug therapy
Cardiomyopathy
cardiotoxicity
Case Report
Chemotherapy
Congestive heart failure
Digoxin
Diuretics
Epirubicin
Female
heart failure
Humans
Hypotension
Internal medicine
left ventricular ejection fraction
Metastases
Metastasis
Middle Aged
Neoplasm Recurrence, Local
Peptidyl-dipeptidase A
Stroke Volume
Ventricle
Ventricular Function, Left
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Summary:Anthracyclines have cardiotoxic side effects. Cardioprotective drugs such as angiotensin-converting enzyme inhibitors and beta-blockers are therefore recommended for patients with anthracycline-induced cardiomyopathy. We herein present a 54-year-old woman with recurrent metastatic breast cancer who developed heart failure (HF) with a left ventricular ejection fraction (LVEF) of 22% after undergoing epirubicin chemotherapy. However, her HF symptoms and low LVEF persisted despite 5 months of cardioprotective therapy and additional oral pimobendan. Pimobendan was discontinued because of ventricular arrhythmia and hypotension. After the start of low-dose (0.125 mg daily) digoxin, her LVEF increased to 42%, and her HF symptoms improved with no adverse events.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.6787-20