Key result
Late doxorubicin cardiotoxicity mimics arrhythmogenic cardiomyopathy despite preserved LVEF, marked by reduced global longitudinal strain.
Why the study?
Doxorubicin-induced cardiotoxicity can manifest years after exposure and may mimic other cardiomyopathies in young patients, complicating diagnosis of delayed cardiotoxicity.
Case Report (n=1)
Late doxorubicin-induced cardiotoxicity can manifest years after exposure and mimic arrhythmogenic cardiomyopathy or ischemia, highlighting the need for multimodality imaging and a high index of suspicion in young cancer survivors.
Reduced GLS may flag delayed doxorubicin cardiotoxicity despite preserved EF; leaves open its value for routine surveillance in survivors.
BACKGROUND: Doxorubicin-induced cardiotoxicity can manifest years after exposure and may mimic other cardiomyopathies in young patients, making the diagnosis of delayed doxorubicin cardiotoxicity challenging in these patients. CASE SUMMARY: cumulative) presented with exertional chest discomfort and palpitations. Resting electrocardiogram and ambulatory monitoring were unremarkable. Transthoracic echocardiography demonstrated preserved ejection fraction (55%-60%) but reduced global longitudinal strain (-15%). Cardiac magnetic resonance revealed low-normal biventricular function with nonischemic septal late gadolinium enhancement and reduced strain. Exercise stress testing demonstrated impaired contractile reserve, septal mechanical dyssynchrony, and exercise-induced QRS prolongation. Coronary computed tomography angiography excluded coronary artery disease. DISCUSSION: This case highlights that anthracycline cardiotoxicity may present late, mimic myocardial ischemia, arrhythmogenic cardiomyopathy, and other cardiomyopathies. TAKE-HOME MESSAGE: A high index of suspicion is required for late cardiotoxicity in young cancer survivors.
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Chedid et al. (2026) conducted a case report in Anthracycline Cardiotoxicity (n=1). Doxorubicin / Anthracycline was evaluated. Late doxorubicin-induced cardiotoxicity presented with preserved ejection fraction (55%-60%) but reduced global longitudinal strain (-15%), mimicking arrhythmogenic cardiomyopathy.
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