Work

Late Anthracycline Cardiotoxicity Mimicking Arrhythmogenic Cardiomyopathy in a Young Adult

Year: 2026

Type: article

Abstract: BACKGROUND: Doxorubicin-induced cardiotoxicity can manifest years after exposure and may mimic other cardiomyopathies in young patients, making the diagnosis of delayed doxorubicin cardiotoxicity challenging in these patients. CASE SUMMARY: cumulative) presented with exertional chest discomfort and palpitations. Resting electrocardiogram and ambulatory monitoring were unremarkable. Transthoracic echocardiography demonstrated preserved ejection fraction (55%-60%) but reduced global longitudinal strain (-15%). Cardiac magnetic resonance revealed low-normal biventricular function with nonischemic septal late gadolinium enhancement and reduced strain. Exercise stress testing demonstrated impaired contractile reserve, septal mechanical dyssynchrony, and exercise-induced QRS prolongation. Coronary computed tomography angiography excluded coronary artery disease. DISCUSSION: This case highlights that anthracycline cardiotoxicity may present late, mimic myocardial ischemia, arrhythmogenic cardiomyopathy, and other cardiomyopathies. TAKE-HOME MESSAGE: A high index of suspicion is required for late cardiotoxicity in young cancer survivors.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.110273

Authors: Maroun Chedid, Collin Barrett, Melanie Sun, Andrew Lesser, Katarxyna Hryniewicz

Institutions: Abbott Northwestern Hospital, Allina Health, Minneapolis Heart Institute Foundation

Language: English

Topic: Chemotherapy-induced cardiotoxicity and mitigation

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850