• PDF / 141,995 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 77 Downloads / 121 Views

DOWNLOAD

REPORT

---

1

S

Myocardial stunning in elderly patients: 2 case reports Two women developed myocardial stunning after receiving cisplatin, doxorubicin and radiotherapy, followed by combretastatins [specific drugs not stated] for anaplastic thyroid cancer. A 71-year-old woman with hypertension received cisplatin and doxorubicin [dosages not stated], followed by radiotherapy for 5 days. On day 6, a combretastatin 45 mg/m2 was administered, and she subsequently developed nausea and vomiting. An ECG, performed 18 hours later, was consistent with anterolateral ischaemia [time to reaction onset not stated]. Her troponin I level peaked at 0.85 ng/mL 32 hours after administration of combretastatins. Echocardiography revealed apical akinesis, and an ejection fraction (EF) of 40-50%. One month later, her EF and periapical akinesis had improved. A cardiac MRI showed normal systolic function of her left ventricle, and normal gadolinium contrast uptake. A 78-year-old woman with hypertension, thrombocytosis and dyslipidaemia received cisplatin, doxorubicin and daily radiotherapy, followed by a combretastatin [dosages not stated]. Nausea and vomiting subsequently developed, and she reported left breast pressure [time to reaction onset not stated]. ECG showed deep inverted T-waves in multiple precordial leads. Her EF was 50-55% with apical septal hypokinesis on echocardiography. Four weeks later, the changes on her ECG had resolved. Her EF had improved, with resolution of wall-motion abnormalities. Mild anterolateral and anteroseptal ischaemia was detected on a pharmacological nuclear stress test. She deferred further treatment, and died from progressive malignancy. Author comment: "Combretastatin, as part of combinedmodality adjuvant therapy, and the possibility of associated myocardial dysfunction should be explored further." Bhakta S, et al. Myocardial stunning following combined modality combretastatinbased chemotherapy: Two case reports and review of the literature. Clinical Cardiology 32: E80-E84, No. 12, Dec 2009. Available from: URL: http:// 803008602 dx.doi.org/10.1002/clc.20685 - USA

0114-9954/10/1294-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

Reactions 27 Mar 2010 No. 1294