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Copyright © 2025, Berhil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Cardiotoxicity from oncologic treatments, including radiotherapy and fluoropyrimidine-based chemotherapy, can manifest years later, leading to pericardial constriction and left ventricular dysfunction in cancer survivors.

We report the case of a 53-year-old breast cancer survivor, treated with surgery, radiotherapy (>25 Gy), and 5-fluorouracil (5-FU) chemotherapy in 2015, who remained cancer-free until a pleural recurrence in 2024, managed with pleurodesis and capecitabine. Six months later, she developed cardiac tamponade requiring pericardial drainage. Transthoracic echocardiography showed a preserved left ventricular ejection fraction (LVEF) (60%), and concurrent subclavian vein thrombosis led to anticoagulation. By early 2025, she developed left ventricular dysfunction (LVEF 45%) with exertional dyspnea classified as New York Heart Association (NYHA) class III. NT-proBNP levels were elevated. Coronary disease was excluded. Cardiac magnetic resonance imaging (MRI) revealed evolving constrictive pericarditis, moderate dysfunction (global longitudinal strain (GLS)-13.5%), biatrial enlargement, and bilateral pleural effusion. Right heart catheterization confirmed adiastole with a deep plateau pattern.

This case highlights a rare late-onset pericardial constriction and ventricular dysfunction in a breast cancer survivor, potentially linked to prior oncologic treatments. These findings underscore the importance of long-term cardiovascular monitoring in cancer survivors.

Details

Title
A Case Report of Pericardial Constriction and Left Ventricular Dysfunction in a Breast Cancer Survivor: Late Cardiotoxicity From Radiotherapy or 5-Fluorouracil
Author
Taha, Berhil 1 ; Lahnaoui Fadoua 1 ; Badre, El Boussaadani 2 ; Ech-Chenbouli Amine 2 ; Raissouni Zainab 2 

 Cardiology, Mohammed VI University Hospital Center, Tangier, MAR 
 Cardiology, Abdelmalek Essaadi University, Tangier, MAR 
University/institution
U.S. National Institutes of Health/National Library of Medicine
Publication year
2025
Publication date
2025
Publisher
Springer Nature B.V.
e-ISSN
21688184
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3225671316
Copyright
Copyright © 2025, Berhil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.