Heart Failure During Breast Cancer Management: A Case Study

Byline: Sandra Cuellar Puri, PharmD, BCOP

Chief Complaint

During a routine follow-up visit, WM, a 48-year-old female, complains of ongoing fatigue since the beginning of cytotoxic chemotherapy, 6 months after initiating trastuzumab.

Physical Exam

• At 6 months following initiation of single-agent trastuzumab, a multigated acquisition (MUGA) scan revealed left ventricular ejection fraction (LVEF) dropped to 49% (baseline 67%; post doxorubicin/cyclophosphamide 65%)
• Otherwise asymptomatic
• Absence of shortness ...