A Case of Epirubicin-Associated Cardiotoxicity Progressing to Life-Threatening Heart Failure and Splenic Thromboembolism

We present the case of a 42-year-old Japanese woman who developed acute heart failure after chemotherapy with epirubicin for breast cancer. Echocardiography revealed a cardiac dysfunction with left ventricular thrombus. Serial serum troponin T tests were positive over a 5-week period, and an endomyocardial biopsy demonstrated ultrastructural lesions which were similar to those caused by cardiotoxicities due to doxorubicin. Although the patient developed splenic thromboembolism, her cardiac function recovered gradually, and she regained full range of her activities. This case report demonstrates that epirubicin-associated cardiotoxicity causes life-threatening heart failure and supportive care is important until the patient recovers from acute intoxication.