Cardiotoxicity Associated with Trastuzumab and Radiotherapy for the Treatment of Metastatic Breast Cancer

We report on a 41-year-old woman with history of left breast cancer treated with partial mastectomy with lymph node dissection and adjuvant chemoradiotherapy who suffered from abdominal fullness for 3 days. Chest radiography showed cardiomegaly with bilateral pleural effusion. ECG showed sinus tachycardia and the echocardiogram showed moderate mitral valve regurgitation, moderate tricuspid valve regurgitation with estimated peak pulmonary hypertension of 29 mmHg, moderate impaired left ventricular global performance and minimal pericardial effusion. The pleural effusion was evaluated by thoracentesis. In addition to presenting the clinical course, we reviewed the medical literature on chemotherapy, radiotherapy and trastuzumab-related cardiotoxicity for a better understanding of the pathophysiology and medical treatment.