TY - CHAP M1 - Book, Section TI - Medications A1 - Higgins, John P. A1 - Ali, Asif A1 - Filsoof, David M. PY - 2016 T2 - Cardiology Clinical Questions, 2e AB - Table Graphic Jump Location|Download (.pdf)|PrintIn patients receiving doxorubicin chemotherapy, monitoring of cardiac function is based upon baseline left ventricular function and total chemotherapy dosage received.HPI: Patient with acute lymphoblastic leukemia, Hodgkin lymphoma, breast, bladder, stomach, or recurrent small cell lung cancer receiving chemotherapy with doxorubicin.PMH: Congestive heart failure, hypertension, coronary artery disease.SH: Alcohol.Dyspnea, rales, tachycardia, jugular–venous distention, hepatomegaly, lower extremity edema.Acute toxicity: Arrhythmias, electrocardiographic abnormalities, a pericarditis–myocarditis syndrome, and ventricular dysfunction during or immediately after administration of anthracyclines.Early toxicity: Observed as dose-related occurrence of CHF in patients that received 500–550 mg/m2 of doxorubicin.Late toxicity: The onset of symptomatic CHF can occur as late as 10–12 years after the last anthracycline dose. Late CHF is due to a nonischemic dilated cardiomyopathy.ECHO: LVEF 100 mg/m2DOXorubicin.EF-EVAL = Refer patient for echocardiogram, radionuclide angiography, or other imaging test for left ventricular Ejection Fraction EVALuation.LVEF-OK = LVEF normal or if follow-up study shows decline in less than 10% from baseline study and absolute EF ≥30%.LVEF65 years are predisposed to cardiotoxicity at lower cumulative doses of doxorubicin.1. Singal PK. Doxorubicin-induced cardiomyopathy. N Engl J Med. 1998;339:900–905.2. Schwartz RG, McKenzie WB, Alexander J, et al. Congestive heart failure and left ventricular dysfunction complicating doxorubicin therapy. Am J Med.1987;82(6):1109–1118.3. Lee BH, Goodenday LS, Muswick GJ, et al. Alterations in left ventricular diastolic function with doxorubicin therapy. J Am Coll Cardiol. 1987;9:184–188. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/05 UR - accesscardiology.mhmedical.com/content.aspx?aid=1173757801 ER -