POSTOPERATIVE CONGESTIVE-HEART-FAILURE AF TER DOXORUBICIN (ADRIAMYCIN) CHEMOTHERAPY

We describe a case of postoperative congestive heart failure in a youn g woman of physical class ASA 1, following breast cancer surgery. Preo peratively she had been treated with doxorubicin (Adriamycin(R)) 450 m g.m(-2), total dose, associated with breast and ovarian radiotherapy. This association was probably the cause of postoperative heart failure . Twenty-four hours after surgery, a two-dimensional echocardiography showed a severe left ventricular dysfunction, whereas preoperative cli nical assessment was unremarkable. Doxorubicin cardiotoxicity can be a cute, subacute and delayed as in our case. Clinical assessment and ECG are not sensitive indicators of such cardiac damage. Preoperative ech ography is the technique of choice for the evaluation of the cardiac s tatus of a patient treated with a high cumulative dose of doxorubicin and mediastinal irradiation. (C) 1998 Elsevier, Paris.