Docetaxel, a taxoid chemotherapy agent, may induce fluid retention. We present a case of metastatic breast cancer in which high output caused by docetaxel-induced fluid retention resulted in heart failure due to left ventricular outflow tract (LVOT) obstruction. A 58-year-old woman presented with exertional dyspnea and anasarca. The jugular venous pressure was elevated, and the carotid pulse was pulsus bisferiens with a spike-and-dome configuration. On auscultation, a mid-late systolic murmur that did not radiate to the neck but increased with the Valsalva maneuver was noted. Echocardiography revealed a left ventricular ejection fraction of 63% with systolic anterior motion (SAM) of the mitral valve, resulting in LVOT obstruction with a resting pressure gradient of 64 mmHg and moderate to severe mitral regurgitation. Treatment with carvedilol, trichlormethiazide, and an increased dose of furosemide gradually improved her symptoms, physical findings, and echocardiographic abnormalities. This case highlights the importance of recognizing high-output heart failure along with LVOT obstruction in patients scheduled to receive docetaxel.
Abstract
Case Reports
eng
37719486
Mase, Taiga, et al. "A Case of Docetaxel-Induced Left Ventricular Outflow Tract Obstruction." Cureus, vol. 15, no. 8, 2023, pp. e43598.
Mase T, Honda S, Yamano M, et al. A Case of Docetaxel-Induced Left Ventricular Outflow Tract Obstruction. Cureus. 2023;15(8):e43598.
Mase, T., Honda, S., Yamano, M., & Kawasaki, T. (2023). A Case of Docetaxel-Induced Left Ventricular Outflow Tract Obstruction. Cureus, 15(8), e43598. https://doi.org/10.7759/cureus.43598
Mase T, et al. A Case of Docetaxel-Induced Left Ventricular Outflow Tract Obstruction. Cureus. 2023;15(8):e43598. PubMed PMID: 37719486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - A Case of Docetaxel-Induced Left Ventricular Outflow Tract Obstruction.
AU - Mase,Taiga,
AU - Honda,Sakiko,
AU - Yamano,Michiyo,
AU - Kawasaki,Tatsuya,
Y1 - 2023/08/16/
PY - 2023/07/31/accepted
PY - 2023/9/18/medline
PY - 2023/9/18/pubmed
PY - 2023/9/18/entrez
KW - docetaxel
KW - fluid retention
KW - heart failure
KW - high-output
KW - left ventricular outflow tract
SP - e43598
EP - e43598
JF - Cureus
JO - Cureus
VL - 15
IS - 8
N2 - Docetaxel, a taxoid chemotherapy agent, may induce fluid retention. We present a case of metastatic breast cancer in which high output caused by docetaxel-induced fluid retention resulted in heart failure due to left ventricular outflow tract (LVOT) obstruction. A 58-year-old woman presented with exertional dyspnea and anasarca. The jugular venous pressure was elevated, and the carotid pulse was pulsus bisferiens with a spike-and-dome configuration. On auscultation, a mid-late systolic murmur that did not radiate to the neck but increased with the Valsalva maneuver was noted. Echocardiography revealed a left ventricular ejection fraction of 63% with systolic anterior motion (SAM) of the mitral valve, resulting in LVOT obstruction with a resting pressure gradient of 64 mmHg and moderate to severe mitral regurgitation. Treatment with carvedilol, trichlormethiazide, and an increased dose of furosemide gradually improved her symptoms, physical findings, and echocardiographic abnormalities. This case highlights the importance of recognizing high-output heart failure along with LVOT obstruction in patients scheduled to receive docetaxel.
SN - 2168-8184
UR - https://www.unboundmedicine.com/prime/citation/37719486/A_Case_of_Docetaxel-Induced_Left_Ventricular_Outflow_Tract_Obstruction.
DB - PRIME
DP - Unbound Medicine
ER -
