Skip to main content
SpringerLink
Log in

Chemotherapy-Induced Takotsubo Syndrome

  • Chapter
  • First Online:
Clinical Pulmonary Research

Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 1114))

Abstract

Cardiovascular complications are a significant problem in systemically treated cancer patients. One such complication is Takotsubo cardiomyopathy, also known as Takotsubo syndrome. It is most frequently defined as a sudden and transient left or right ventricular systolic dysfunction; mimicking acute coronary syndrome, but without the associated changes in coronary arteries. Takotsubo syndrome is a relatively little known complication that appears in the course of oncological treatment, and its incidence has not yet been established. In this study, we reviewed Medline database according to case reports concerning takotsubo syndrome appearing after systemic treatment in oncological patients. We took into consideration all types of anticancer drugs. We reviewed the changes reported in the electrocardiography, echocardiography, and coronary angiography, and also the level of troponin, a marker of acute coronary syndrome elevation. In view of the increasing frequency of cardiac complications reported in patients receiving systemic oncological treatment, Takotsubo syndrome appears to be underdiagnosed. However, the syndrome may be linked to potentially fatal complications such as cardiogenic shock or cardiac arrest. Therefore, it seems essential to carry out appropriate diagnostic procedures for every patient experiencing clinical side effects of onco-pharmacotherapy. In patients with chest pain and dyspnea during or after treatment, Takotsubo syndrome should be considered, particularly that the syndrome requires a different therapy approach than that used in a coronary syndrome. Diagnostic procedures should include echocardiogram and the assessment of myocardial necrosis markers and natriuretic peptides.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Basselin C, Fontanges T, Descotes J, Chevalier P, Bui-Xuan B, Feinard G, Timour Q (2011) 5–Fluorouracil-induced Tako-Tsubo-like syndrome. Pharmacotherapy 31:226

    Article  PubMed  Google Scholar 

  • Baumann S, Huseynov A, Goranova D, Faust M, Behnes M, Nolte F, Heidenreich D, Hofmann WK, Borggrefe M, Akin I, Klein S (2014) Takotsubo cardiomyopathy after systemic consolidation therapy with high-dose intravenous cytarabine in a patient with acute myeloid leukemia. Oncol Res Treat 37:487–490

    Article  PubMed  Google Scholar 

  • Brunetti ND, Santoro F, De Gennaro L, Correale M, Gaglione A, Di Biase M (2016) Drug treatment rates with beta-blockers and ACE-inhibitors/angiotensin receptor blockers and recurrences in takotsubo cardiomyopathy: a meta-regression analysis. Int J Cardiol 214:340–342

    Article  PubMed  Google Scholar 

  • Budnik M, Piatkowski R, Kochanowski J, Glowczynska R, Gorko D, Kowalik R, Pietrasik A, Opolski G (2015) The oldest patient with takotsubo cardiomyopathy. J Geriatr Cardiol 12:588–589

    PubMed  PubMed Central  Google Scholar 

  • Budnik M, Kochanowski J, Piatkowski R, Wojtera K, Peller M, Gaska M, Glowacka P, Karolczak P, Ochijewicz D, Opolski G (2016) Simple markers can distinguish Takotsubo cardiomyopathy from ST segment elevation myocardial infarction. Int J Cardiol 219:417–420

    Article  PubMed  Google Scholar 

  • Burgy M, Brossat H, Barthelemy P, Imperiale A, Trinh A, Hazam CA, Bergerat JP, Mathelin C (2014) First report of trastuzumab treatment after postoperative takotsubo cardiomyopathy. Anticancer Res 34:3579–3582

    CAS  PubMed  Google Scholar 

  • Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (2004) Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med 141:858–865

    Article  PubMed  Google Scholar 

  • Coli S, Pigazzani F, Gaibazzi N (2015) Midventricular takotsubo cardiomyopathy after oxaliplatin infusion: an unreported side effect. J Cardiovasc Med 16:646–649

    Article  Google Scholar 

  • Damodaran S, Mrozek E, Liebner D, Kendra K (2014) Focal takotsubo cardiomyopathy with high-dose interleukin-2 therapy for malignant melanoma. J Natl Compr Cancer Netw 12(12):1666–1670

    Article  Google Scholar 

  • Drímal J, Zúrová-Nedelcevová J, Knezl V, Sotníková R, Navarová J (2006) Cardiovascular toxicity of the first line cancer chemotherapeutic agents: doxorubicin, cyclophosphamide, streptozotocin and bevacizumab. Neuro Endocrinol Lett 27(Suppl 2):176–179

    PubMed  Google Scholar 

  • Finsterer J, Stöllberger C, Pulgram T (2015) Paraneoplastic takotsubo syndrome with ventricular thrombus and stroke. Herz 40:632–634

    Article  CAS  PubMed  Google Scholar 

  • Franco TH, Khan A, Joshi V, Thomas B (2008) Takotsubo cardiomyopathy in two men receiving bevacizumab for metastatic cancer. Ther Clin Risk Manag 4:1367–1370

    Article  PubMed  PubMed Central  Google Scholar 

  • Gianni M, Dentali F, Grandi AM, Sumner G, Hiralal R, Lonn E (2006) Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J 27:1523–1529

    Article  PubMed  Google Scholar 

  • Goel S, Sharma A, Garg A, Chandra A, Shetty V (2014) Chemotherapy induced takotsubo cardiomyopathy. World J Clin Cases 2:565–568

    Article  PubMed  PubMed Central  Google Scholar 

  • Grunwald MR, Howie L, Diaz LA (2012) Takotsubo cardiomyopathy and fluorouracil: case report and review of the literature. J Clin Oncol 30:e11–e14

    Article  PubMed  Google Scholar 

  • Khakoo AY, Halushka MK, Rame JE, Rodriguez ER, Kasper EK, Judge DP (2005) Reversible cardiomyopathy caused by administration of interferon alpha. Nat Clin Pract Cardiovasc Med 2:53–57

    Article  PubMed  Google Scholar 

  • Khanji M, Nolan S, Gwynne S, Pudney D, Ionescu A (2013) Tako-Tsubo syndrome after trastuzumab – an unusual complication of chemotherapy for breast cancer. Clin Oncol (R Coll Radiol) 25:329

    Article  CAS  Google Scholar 

  • Kim L, Karas M, Wong SC (2008) Chemotherapy-induced takotsubo cardiomyopathy. J Invasive Cardiol 20:338–340

    Google Scholar 

  • Klag T, Cantara G, Ong P, Kaufmann M, Sechtem U, Athanasiadis A (2014) Epicardial coronary artery spasm as cause of capecitabine-induced takotsubo cardiomyopathy. Clin Res Cardiol 103:247–250

    Article  PubMed  Google Scholar 

  • Knott K, Starling N, Rasheed S, Foran J, Cafferkey C, Rosen S, Nicholson A, Baksi J, Lyon A (2014) A case of Takotsubo syndrome following 5-fluorouracil chemotherapy. Int J Cardiol 177:e65–e67

    Article  PubMed  Google Scholar 

  • Kobayashi N, Hata N, Yokoyama S, Shinada T, Shirakabe A, Mizuno K (2009) A case of Takotsubo cardiomyopathy during 5-fluorouracil treatment for rectal adenocarcinoma. J Nippon Med Sch 76:27–33

    Article  PubMed  Google Scholar 

  • Lim SH, Wilson SM, Hunter A, Hill J, Beale P (2013) Takotsubo cardiomyopathy and 5-fluorouracil: getting to the heart of the matter. Case Rep Oncol Med 2013:206765

    PubMed  PubMed Central  Google Scholar 

  • Lyon AR, Bossone E, Schneider B, Sechtem U, Citro R, Underwood SR, Sheppard MN, Figtree GA, Parodi G, Akashi YJ, Ruschitzka F, Filippatos G, Mebazaa A, Omerovic E (2016) Current state of knowledge on takotsubo syndrome: a position statement from the taskforce on Takotsubo syndrome of the heart failure Association of the European Society of Cardiology. Eur J Heart Fail 18:8–27

    Article  PubMed  Google Scholar 

  • Malley T, Watson E (2016) A case of takotsubo cardiomyopathy after chemotherapy. Oxf Med Case Rep 2016:55–58

    Article  Google Scholar 

  • Napora M, Ganowicz E, Gorska R (2013) Correlation between the state of periodontal tissues and selected cardiovascular parameters in patients with type 2 diabetes. Centr Eur J Immunol 38(4):556–561

    Article  Google Scholar 

  • Ng KH, Dearden C, Gruber P (2015) Rituximab-induced Takotsubo syndrome: more cardiotoxic than it appears? BMJ Case Rep 2015:bcr2014208203. https://doi.org/10.1136/bcr-2014-208203

    Article  PubMed  PubMed Central  Google Scholar 

  • Opolski G, Budnik M, Kochanowski J, Kowalik R, Piatkowski R, Kochman J (2016) Four episodes of takotsubo cardiomyopathy in one patient. Int J Cardiol 203:53–54

    Article  PubMed  Google Scholar 

  • Ovadia D, Esquenazi Y, Bucay M, Bachier CR (2015) Association between takotsubo cardiomyopathy and axitinib: case report and review of the literature. J Clin Oncol 33(1):e1–e3

    Article  PubMed  Google Scholar 

  • Ozturk MA, Ozveren O, Cinar V, Erdik B, Oyan B (2013) Takotsubo syndrome: an underdiagnosed complication of 5–fluorouracil mimicking acute myocardial infarction. Blood Coagul Fibrinolysis 24:90–94

    Article  CAS  PubMed  Google Scholar 

  • Qasem A, Bin Abdulhak AA, Aly A, Moormeier J (2016) Capecitabine-induced takotsubo cardiomyopathy: a case report and literature review. Am J Ther 23(5):e1188–e1192

    Article  PubMed  Google Scholar 

  • Saif MW, Shah MM, Shah AR (2009) Fluoropyrimidine-associated cardiotoxicity: revisited. Expert Opin Drug Saf 8:191–202

    Article  CAS  PubMed  Google Scholar 

  • Scappaticci FA, Skillings JR, Holden SN, Gerber HP, Miller K, Kabbinavar F, Bergsland E, Ngai J, Holmgren E, Wang J, Hurwitz H (2007) Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. J Natl Cancer Inst 99:1232–1239

    Article  PubMed  Google Scholar 

  • Senkus E, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rutgers E, Zackrisson S, Cardoso F; ESMO Guidelines Committee (2015) Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up Ann Oncol 26(suppl 5):v8–v30

    Article  PubMed  Google Scholar 

  • Singh SB, Harle IA (2014) Takotsubo cardiomyopathy secondary in part to cancer-related pain crisis: a case report. J Pain Symptom Manag 48:137–142

    Article  Google Scholar 

  • Sorrentino MF, Kim J, Foderaro AE, Truesdell AG (2012) 5-Fluorouracil induced cardiotoxicity: review of the literature. Cardiol J 19:453–458

    Article  PubMed  Google Scholar 

  • Stewart T, Pavlakis N, Ward M (2010) Cardiotoxicity with 5-fluorouracil and capecitabine: more than just vasospastic angina. Intern Med J 40:303–307

    Article  CAS  PubMed  Google Scholar 

  • Sundaravel S, Alrifai A, Kabach M, Ghumman W (2017) FOLFOX induced takotsubo cardiomyopathy treated with impella assist device. Case Rep Cardiol 2017:8507096

    PubMed  PubMed Central  Google Scholar 

  • Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, Cammann VL et al (2015) Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med 373:929–938

    Article  CAS  PubMed  Google Scholar 

  • Yeh ET, Bickford CL (2009) Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. J Am Coll Cardiol 53:2231–2247

    Article  CAS  PubMed  Google Scholar 

  • Y-Hassan S, Tornvall P, Törnerud M, Henareh L (2013) Capecitabine caused cardiogenic shock through induction of global Takotsubo syndrome. Cardiovasc Revasc Med 14(1):57–61

    Article  PubMed  Google Scholar 

  • Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GYH, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM; ESC Scientific Document Group (2016) 2016 ESC position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for practice guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J 37:2768–2801

    Article  PubMed  Google Scholar 

Download references

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

  1. First Department of Cardiology, Warsaw Medical University, Warsaw, Poland

    Monika Budnik, Janusz Kochanowski & Grzegorz Opolski

  2. Department of Uro–Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland

    Jakub Kucharz, Paweł Wiechno & Tomasz Demkow

  3. Department of Laboratory Diagnostics and Clinical and Clinical Immunology of Developmental Age, Warsaw Medical University, Warsaw, Poland

    Elżbieta Górska

Authors
  1. Monika Budnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jakub Kucharz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paweł Wiechno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tomasz Demkow
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Janusz Kochanowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elżbieta Górska
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Grzegorz Opolski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jakub Kucharz .

Editor information

Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Budnik, M. et al. (2018). Chemotherapy-Induced Takotsubo Syndrome. In: Pokorski, M. (eds) Clinical Pulmonary Research. Advances in Experimental Medicine and Biology(), vol 1114. Springer, Cham. https://doi.org/10.1007/5584_2018_222

Download citation

Publish with us

Policies and ethics

Search

Navigation