Bradycardia as a rare symptom of cisplatin cardiotoxicity: A case report
- Authors:
- Jakub Kucharz
- Anna Michalowska‑Kaczmarczyk
- Aneta L. Zygulska
- Jolanta Wojtak
- Wieslaw Pawlik
- Roman M. Herman
- Krzysztof Krzemieniecki
View Affiliations
Affiliations: Department of Oncology, University Hospital in Kraków, Kraków 31‑531, Poland, Section of Computed Tomography, Second Department of Internal Medicine, University Hospital in Kraków, Kraków 31‑066, Poland, Department of Experimental and Clinical Surgery, Jagiellonian University Medical College, Kraków 31‑126, Poland
- Published online on: February 8, 2016 https://doi.org/10.3892/ol.2016.4195
-
Pages:
2297-2299
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Abstract
Cisplatin (DDP) is one of the most frequently used chemotherapeutic agents, and has a characteristic toxicity profile. For DDP, complications affecting the cardiovascular system, which are typical for certain other agents, are rare; however, their occurrence may lead to life‑threatening conditions. To the best of our knowledge, there are few reported cases of DDP‑induced bradycardia in the relevant medical literature. The current report presents the case of a 58-year-old patient diagnosed with metastatic neuroendocrine carcinoma with a primary lesion in the posterior mediastinum, who was treated with DDP and etoposide chemotherapy. Following the initial chemotherapy cycle, the patient experienced severe symptomatic bradycardia (a drop in heart rate to 40 bpm), with the corrected QT interval prolonged to 424 msec. The patient's condition required close monitoring and treatment. Similar symptoms occurred following each of the three cycles of chemotherapy. Imaging studies performed following the third treatment cycle revealed disease progression, and the patient was referred for palliative care. Reports have indicated that damage to the cardiovascular system, including cardiac ischemia, diastolic disturbances, hypertension and microalbuminuria, may be associated with DDP‑based therapy. However, the mechanism of DDP‑associated cardiac toxicity remains to be elucidated. It may be induced by factors including direct toxicity, ion imbalance, heart infiltration and, in the case of neuroendocrine tumors, the influence of tumor excretions.
View References
|
1
|
Prestayko AW, D'Aoust JC, Issell BF and
Crooke ST: Cisplatin (cis-diamminedichloroplatinum II). Cancer
Treat Rev. 6:17–39. 1979. View Article : Google Scholar : PubMed/NCBI
|
|
2
|
Loehrer PJ and Einhorn LH: Drugs five
years later. Cisplatin. Ann Intern Med. 100:704–713. 1984.
View Article : Google Scholar : PubMed/NCBI
|
|
3
|
Bovelli D, Plataniotis G and Roila F: ESMO
Guidelines Working Group: Cardiotoxicity of chemotherapeutic agents
and radiotherapy-related heart disease: ESMO Clinical Practice
Guidelines. Ann Oncol. 21(Suppl 5): v277–v282. 2010. View Article : Google Scholar : PubMed/NCBI
|
|
4
|
Yeh ET, Tong AT, Lenihan DJ, Yusuf SW,
Swafford J, Champion C, Durand JB, Gibbs H, Zafarmand AA and Ewer
MS: Cardiovascular complications of cancer therapy: Diagnosis,
pathogenesis, and management. Circulation. 109:3122–3131. 2004.
View Article : Google Scholar : PubMed/NCBI
|
|
5
|
Oken MM, Creech RH, Tormey DC, Horton J,
Davis TE, McFadden ET and Carbone PP: Toxicity and response
criteria of the Eastern Cooperative Oncology Group. Am J Clin
Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI
|
|
6
|
Eisenhauer EA, Therasse P, Bogaerts J,
Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S,
Mooney M, et al: New response evaluation criteria in solid tumours:
Revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247.
2009. View Article : Google Scholar : PubMed/NCBI
|
|
7
|
Meinardi MT, Gietema JA, van der Graaf WT,
van Veldhuisen DJ, Runne MA, Sluiter WJ, de Vries EG, Willemse PB,
Mulder NH, van den Berg MP, et al: Cardiovascular morbidity in
long-term survivors of metastatic testicular cancer. J Clin Oncol.
18:1725–1732. 2000.PubMed/NCBI
|
|
8
|
Tassinari D, Sartori S, Drudi G, Panzini
I, Gianni L, Pasquini E, Abbisciano V, Ravaioli A and Iorio D:
Cardiac arrhythmias after cisplatin infusion: Three case reports
and a review of the literature. Ann Oncol. 8:1263–1267. 1997.
View Article : Google Scholar : PubMed/NCBI
|
|
9
|
Schlaeffer F, Tovi F and Leiberman A:
Cisplatin-induced bradycardia. Drug Intell Clin Pharm. 17:899–901.
1983.PubMed/NCBI
|
|
10
|
Altundağ O, Celik I and Kars A: Recurrent
asymptomatic bradycardia episodes after cisplatin infusion. Ann
Pharmacother. 35:641–642. 2001. View Article : Google Scholar : PubMed/NCBI
|
|
11
|
Blachley JD and Hill JB: Renal and
electrolyte disturbances associated with cisplatin. Ann Intern Med.
95:628–632. 1981. View Article : Google Scholar : PubMed/NCBI
|
|
12
|
Maier HC and Sommers SC: Neuroendocrine
carcinoma of lung associated with bradycardia and episodic cardiac
asystole. Ann Thorac Surg. 41:560–562. 1986. View Article : Google Scholar : PubMed/NCBI
|
