Open AccessIntermittent left bundle branch block and acute heart failure in trastuzumab-induced cardiotoxicity
Author(s) -
Ravi Masson,
Hooman Bakhshi,
Tariq Haddad
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-236009
Subject(s) - medicine , trastuzumab , left bundle branch block , heart failure , cardiotoxicity , cardiology , cardiomyopathy , chest pain , myocarditis , breast cancer , cancer , chemotherapy
A 70-year-old woman with HER2+/ER+ breast cancer on adjuvant trastuzumab therapy without a history of cardiovascular disease presented with respiratory failure from influenza and was found to have intermittent left bundle branch block (LBBB) with new onset systolic heart failure. Her course was complicated by polymorphic ventricular tachycardia and recurrent chest pain. Significant investigations included a normal cardiac MRI and cardiac catheterisation with unobstructed coronaries. It was determined that the aetiology of her heart failure was trastuzumab-induced cardiotoxicity after comprehensive workup. This case highlights an uncommon presentation of LBBB and the steps taken to diagnose a rare cardiomyopathy.