Reverse takotsubo cardiomyopathy associated with oxaliplatin cardiotoxicity. A case report

Roxana I. Ibarra-Quintero, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Jalisco, Mexico
Liliana E. Ramos-Villalobos, Department of Cardiology, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca,” Guadalajara, Jalisco, Mexico
Itzel E. López-Perea, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Jalisco, Mexico
Andrea M. Tirado-Martinez, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Jalisco, Mexico
José M. Á. Llamas-Montes, Adult Emergency Service, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca,” Guadalajara, Jalisco, Mexico

The following is the case of a 47-year-old female patient diagnosed with stage IV-A colorectal cancer who developed acute pulmonary edema and cardiogenic shock following oxaliplatin administration. A transthoracic echocardiogram revealed severe left ventricle systolic dysfunction with a pattern of basal akinesia and apical hyperkinesia, possibly precipitated by the stress of the anaphylactoid reaction. The case is noteworthy because the association between oxaliplatin and Takotsubo cardiomyopathy (TCM) is extremely rare, with few cases reported worldwide. Therefore, TCM should be considered in the differential diagnosis of acute ventricular dysfunction in patients with cancer, particularly when temporally associated with oxaliplatin administration, to guide cardiovascular management and subsequent decisions regarding cancer therapy.

Keywords: Takotsubo cardiomyopathy. Oxaliplatin. Cardiotoxicity. Chemotherapy.