title: [Biventricular heart failure in patient treated with anthracycline in childhood: myocardial dysfunction is not always the cause].
abstract: Anthracyclines, found to be efficacious in the treatment of a broad spectrum of pediatric malignancies, are cardiotoxic and may lead to heart failure even a long time after successful treatment of cancer. It is thought that subtle abnormalities can progress to the more permanent myocardial disease, resulting in cardiomyopathy which may progress to congestive heart failure. There are some precipitating factors leading to the sudden onset of cardiac symptoms such as increase in afterload or preload. We describe a young patient with congestive heart failure treated with doxorubicin (cumulative mean dose 420 mg/m2) in infancy because of pelvic sarcoma in whom the appearance of symptoms was related to pulmonary embolism. Four years before hospital admission, the patient presented echocardiographic abnormalities such as left ventricular fractional shortening and thickness reduction and he was treated with ACE-inhibitors. The myocardial ischemia, which is present in pulmonary embolism, probably worsened the left ventricular systolic function and caused congestive heart failure.
authors.affiliation: Cattedra di Cardiologia, Dipartimento di Scienze Cardiotoraciche e Respiratorie, Azienda Ospedaliera Monaldi, Napoli. dianal.iarussi@unina2.it
authors.forename: Diana
authors.initials: D
authors.lastname: Iarussi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Martino
authors.forename: Carola
authors.initials: C
authors.lastname: Iacono
authors.forename: Paolo
authors.initials: P
authors.lastname: Indolfi
authors.forename: Roberto
authors.initials: R
authors.lastname: Muto
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D004317:Doxorubicin / Q000009:adverse effects*; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D008297:Male; D013997:Time Factors
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin