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Cardiotoxicity is not always the only explanation - a case report Cover

Cardiotoxicity is not always the only explanation - a case report

Romanian Journal of Cardiology
Volume 35 (2025): Issue 4 (December 2025)
By: Andreea-Madalina Varvara,  Irina Serban and  Ruxandra Jurcuţ  
Open Access
|Nov 2025

Figures & Tables

Figure 1

Electrocardiogram findings showing T wave inversion in inferior and lateral leads with a QTc of 470 ms (A), Admission chest X-ray reflecting prominent convexity of the lower right and left arches suggestive for left atria, respectively left ventricle enlargement, and marked interstitial pulmonary pattern (B), After 3 months, the post-implant radiography of the patient with unicameral implantable cardioverter-defibrillator (C).

Figure 2

Assessment of right ventricle function showing a fractional area change (FAC) estimation of 29.9% (A) and a tricuspid annular systolic velocity (S′) by tissue Doppler imaging (TDI) of 8,33 cm/s; a peak velocity of the tricuspid regurgitation envelope of 2,76 cm/s indicates a low probability for pulmonary hypertension (C).

Figure 3

The pedigree of the family shows, with the black arrow, the proband with dilated cardiomyopathy (DCM) and her familial history of cardiomyopathy and sudden cardiac death (SCD) of her mother at 53 years old and SCD of her brother at 34 years old.

Figure 4

Dynamic evolution of echocardiographic and biological parameters at baseline and after one year of optimal treatment. Left ventricular outflow tract velocity-time integral (LVOT VTI) measured 8.5 cm at baseline (A) and 16.4 cm after one year (F). A two-dimensional view of the severe mitral regurgitation jet in color Doppler imaging in the apical 4-chamber view showed a turbulent jet with a large proximal flow convergence region extending deep into the left atrium (B), which was alleviated to a mild-moderate degree after 1 year (G). Assessment of right ventricular function showed a fractional area change (FAC) estimation of 29.9% at baseline (C) and 49% after one year. The dynamic changes of left ventricle ejection fraction (D) and NT-proBNP (E) at admission and after one year of treatment.
DOI: https://doi.org/10.2478/rjc-2025-0033 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
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Language: English
Page range: 280 - 285
Published on: Nov 26, 2025
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
Dilated cardiomyopathy,
hereditary cardiomyopathy,
genetic test,
chemotherapy-related cardiac dysfunction,
second hit theory
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Cardiology,
Surgery,
Cardiac surgery,
Pediatrics and juvenile medicine,
Paediatric cardiology

© 2025 Andreea-Madalina Varvara, Irina Serban, Ruxandra Jurcuţ, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

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