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Chemotherapy-Induced Takotsubo Syndrome

  • Monika Budnik
  • Jakub Kucharz
  • Paweł Wiechno
  • Tomasz Demkow
  • Janusz Kochanowski
  • Elżbieta Górska
  • Grzegorz Opolski
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1114)

Abstract

Cardiovascular complications are a significant problem in systemically treated cancer patients. One such complication is Takotsubo cardiomyopathy, also known as Takotsubo syndrome. It is most frequently defined as a sudden and transient left or right ventricular systolic dysfunction; mimicking acute coronary syndrome, but without the associated changes in coronary arteries. Takotsubo syndrome is a relatively little known complication that appears in the course of oncological treatment, and its incidence has not yet been established. In this study, we reviewed Medline database according to case reports concerning takotsubo syndrome appearing after systemic treatment in oncological patients. We took into consideration all types of anticancer drugs. We reviewed the changes reported in the electrocardiography, echocardiography, and coronary angiography, and also the level of troponin, a marker of acute coronary syndrome elevation. In view of the increasing frequency of cardiac complications reported in patients receiving systemic oncological treatment, Takotsubo syndrome appears to be underdiagnosed. However, the syndrome may be linked to potentially fatal complications such as cardiogenic shock or cardiac arrest. Therefore, it seems essential to carry out appropriate diagnostic procedures for every patient experiencing clinical side effects of onco-pharmacotherapy. In patients with chest pain and dyspnea during or after treatment, Takotsubo syndrome should be considered, particularly that the syndrome requires a different therapy approach than that used in a coronary syndrome. Diagnostic procedures should include echocardiogram and the assessment of myocardial necrosis markers and natriuretic peptides.

Keywords

Cancer Cardiomyopathy Cardiotoxicity Chemotherapy Coronary syndrome Takotsubo syndrome 

Notes

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Monika Budnik
    • 1
  • Jakub Kucharz
    • 2
  • Paweł Wiechno
    • 2
  • Tomasz Demkow
    • 2
  • Janusz Kochanowski
    • 1
  • Elżbieta Górska
    • 3
  • Grzegorz Opolski
    • 1
  1. 1.First Department of CardiologyWarsaw Medical UniversityWarsawPoland
  2. 2.Department of Uro–OncologyMaria Sklodowska-Curie Memorial Cancer Center and Institute of OncologyWarsawPoland
  3. 3.Department of Laboratory Diagnostics and Clinical and Clinical Immunology of Developmental AgeWarsaw Medical UniversityWarsawPoland

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