AI Article Synopsis
- Platinum-based chemotherapy, specifically BEP (bleomycin, etoposide, cisplatin), is the standard first-line treatment for non-epithelial ovarian tumors, but bleomycin can cause rare cardiovascular toxicity.
- A 41-year-old woman undergoing BEP for an ovarian granulosa tumor experienced severe chest pain during the bleomycin infusion, which led to the infusion being stopped and the discovery of electrocardiographic signs of myocardial ischemia.
- Following symptom resolution and further evaluation, chemotherapy resumed without bleomycin, highlighting the importance of monitoring cardiovascular health in patients receiving this treatment, especially those with existing risk factors.
Article Abstract
Introduction: Platinum-based chemotherapeutic regimens, including BEP (bleomycin, etoposide, cisplatin) represent the standard of care, first line therapy in non-epithelial ovarian tumours. Cardiovascular toxicity is a rare adverse effect of bleomycin.
Case Report: A 41-year-old woman with ovarian granulosa tumor, treated with first line BEP chemotherapy experienced chest discomfort rapidly progressing to severe precordial pain during bleomycin infusion. The infusion was stopped and electrocardiographic changes indicative of myocardial ischemia were revealed. Anti-anginal and anti-thrombotic treatment was introduced. Cardiac enzymes were not elevated and echocardiographic findings showed no wall motion abnormalities. Twenty four hours after the episode the elctrocardiographic changes insisted and chemotherapy was decided to be continued, excluding bleomycin, with no symptom recurrence.
Discussion: Cardiovascular complications pose a rare but potential fatal adverse effect of BEP chemotherapy and should be carefully addressed, especially in patients with additional cardiovascular risk factors. Physicians dealing with bleomycin-based therapies may find this knowledge useful for a more comprehensive evaluation of chest pain syndromes in those patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743631 | PMC |
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