Cardiotoxicity in a patient with prostate adenocarcinoma under treatment with gonadotropin releasing hormone agonist

Introduction: Perfecting the methods that are used within prostate cancer therapy has resulted in increasing the efficiency of treatment and extended the survival of patients. However, oncologic therapy is accompanied by increasing the frequency of negative side effects, including cardiac toxicity, which becomes a serious problem that affects the quality of life and survival of patients with neoplasm. Mechanisms of cardiac impairment are different for the various cardiotoxic agents, but symptoms usually involve heart failure, ischemic heart disease, arrhythmias, hypertension, valvular disease, pericarditis and myocarditis. Methods: Evaluation of the therapeutic and evolutive particularities in a patient with prostate adenocarcinoma during treatment with gonadotropin releasing hormone agonist – GOSERELINUM, that gets complicated with myocardial ischemia. Results: We present the case of a patient aged 68, hypertensive, non-smoker, known with prostate adenocarcinoma, who has had a cardiological evaluation at the beginning of the oncology treatment with Goserelinum. The resting ECG showed RS, without ischemic changes. 6 months after the beginning of the treatment, the patient presents himself at the periodic check-up, when he is completely asymptomatic. Biologically, without the turn of enzymes of myocardial necrosis, with inflammatory evidence in normal limits. The electrocardiogram showed RS, AV 64 bpm, elevation of the ST segment of up to 2 mm in V1-V3, with negative T wave V2-V5. Echocardiographically, heart is normally structured without segmental LV wall motion disorders. Coronary angio computer tomographies highlighted non significant coronary stenosis. Conclusions: We interpret the case as a toxic cardiopathy in a patient with prostate adenocarcinoma induced by treatment with GOSERELINUM. Practices used to reduce the risk of cardiotoxic effects of cancer therapy include the evaluation of cardiac functions before treatment and constant monitoring during and after treatment. According to data from literature, the specific oncology treatment does not stop, under close cardiologic and oncologic supervision; to this it is added the cardioprotective treatment. Understanding the cardiotoxic mechanisms produced by agents that were used within prostate cancer treatment, it may help in developing effective cardioprotective substances.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)