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Signa Vitae

Journal of Intensive Care and Emergency Medicine

Acute heart failure due to the left atrial myxoma causing mitral valve obstruction

Abstract

A 64 year-old woman without history of cardiovascular diseases and without cardiovascular risk factors was referred to our hospital because of acute heart failure. A real-time three-dimensional echocardiography (3D) revealed left atrium tumor causing mitral valve obstruction. 3D characteristics of the tumor were highly suggestive of cardiac myxoma. Surgical excision was successfully performed and myxoma was confirmed histologically. Although cardiac myxoma typically presents a silent heart failure, our case suggests that it should be even considered a cause of acute heart failure, especially in patients with no previous history or signs of cardiovascular disease.

Key words: acute heart failure, echocardiography, myxoma.

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Anthracycline-related cardiotoxicity: risk factors and therapeutic options in childhood cancers

Abstract

Anthracyclines play an important role in chemotherapeutic regimens for a wide spectrum of childhood tumors, but they can cause cytotoxic damage to cardiac cells, especially in combination with radiotherapy. Furthermore, cardiotoxicity increases with the cumulative dose and may lead to congestive heart failure and cardiomyopathy. Other factors, including age, pre-existing cardiac disease, length of follow-up, gender, route of administration, concomitant exposure to some chemotherapeutic drugs, trisomy 21 and black race, play a role in increasing the risk of cardiac dysfunction. The prevention of anthracycline-induced cardiotoxicity is mandatory as children are expected to survive for decades after being cured of their cancer. The purpose of this work is to point out the major risk factors of cardiotoxicity in children and to summarize some strategies to limit or prevent this complication and to treat the development of acute heart failure.

Keywords: anthracycline, cardiotoxicity, childhood cancer, risk factors, prevention, acute heart failure

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