title: Bleomycin cardiotoxicity during chemotherapy for an ovarian germ cell tumor.
abstract: BACKGROUND
  Platinum-based chemotherapeutic regimens, including BEP (bleomycin, etoposide, cisplatin) represent the standard of care, first line therapy in non-epithelial ovarian tumours. Cardiovascular toxicity is a rare adverse effect of bleomycin.
  
  
  METHODS
  A 41-year-old woman with ovarian granulosa tumor, treated with first line BEP chemotherapy experienced chest discomfort rapidly progressing to severe precordial pain during bleomycin infusion. The infusion was stopped and electrocardiographic changes indicative of myocardial ischemia were revealed. Anti-anginal and anti-thrombotic treatment was introduced. Cardiac enzymes were not elevated and echocardiographic findings showed no wall motion abnormalities. Twenty four hours after the episode the elctrocardiographic changes insisted and chemotherapy was decided to be continued, excluding bleomycin, with no symptom recurrence.
  
  
  CONCLUSIONS
  Cardiovascular complications pose a rare but potential fatal adverse effect of BEP chemotherapy and should be carefully addressed, especially in patients with additional cardiovascular risk factors. Physicians dealing with bleomycin-based therapies may find this knowledge useful for a more comprehensive evaluation of chest pain syndromes in those patients.
authors.affiliation: 1 Department of Clinical Oncology-Chemotherapy, Theagenio Cancer Hospital, Thessaloniki, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Didagelos
authors.affiliation: 1 Department of Clinical Oncology-Chemotherapy, Theagenio Cancer Hospital, Thessaloniki, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Boutis
authors.affiliation: 1 Department of Clinical Oncology-Chemotherapy, Theagenio Cancer Hospital, Thessaloniki, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Diamantopoulos
authors.affiliation: 1 Department of Clinical Oncology-Chemotherapy, Theagenio Cancer Hospital, Thessaloniki, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Sotiriadou
authors.affiliation: 1 Department of Clinical Oncology-Chemotherapy, Theagenio Cancer Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Fotiou
keywords: BEP chemotherapy; cardiotoxicity; chest pain; myocardial ischemia; ovarian cancer