Today we heard a case of congestive heart failure in a patient who had previously received chest radiotherapy and doxorubicin (adriamycin) as part of her chemotherapy for breast cancer. Doxorubicin has the potential to cause an irreversible cardiomyopathy, and in the absence of known cardiac disease in this patient this was likely the cause of her cardiomyopathy.
There are multiple causes of cardiomyopathy including, but not limited to:
- Ischemic - secondary to MI/ischemia
- Toxic - E.g. adriamycin, alcohol
- Restrictive - Due to deposition of sustances such as amyloid, iron (hemochromatosis), glycogen breakdown products (Gaucher's), idiopathic
- Infectious - Viral (coxsackie virus, HIV), Chagas disease
- Auto-immune
- Genetic - familial dilated cardiomyopathies, hypertrophic cardiomyopathy
- Post-partum
In an earlier blog I provided a great reference for
CHF management as well as the link to the nejm article on constrictive pericarditis today's discussant mentioned.
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