A 55-year-old woman with breast cancer develops shortness of breath and poor exercise tolerance while being treated with doxorubicin. Which of the following is the most likely cause of these symptoms?
Dilated cardiomyopathy
Obstructive pulmonary disease
Pulmonary hypertension
Restrictive cardiomyopathy
Restrictive pulmonary disease
Correct answer
Dilated cardiomyopathy
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correct answer: A
Doxorubicin has a well known side-effect profile of (A) dilated cardiomyopathy, with dose-related CHF and transient ECG abnormalities occuring in over 10% of patients. Other side effects include leukopenia (75%) nausea and vomiting (21-55%). It is not as closely associated with restrictive cardiomyopathy or pulmonary disease. The chemotherapeutic agent bleomycin is better known for causing pulmonary toxicity, particularly pulmonary fibrosis.