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45 yr old male undergoing chemotherapy for leukemia. Cancer seemed to
be in remission and patient was discharged from Oncology with an
excellent prognosis. Midway through chemotherapy, patient
developed recurrent tachycardia and was rehospitalized for the cardiac
abnormalities. There also have been two episodes of "overwhelming
chills" accompanied by intense shivering that was almost to the point
of seizures. The consulting cardiologist is of the opinion that the
tachycardia and "chill episodes" are the result a congenital
condition which is entirely unrelated to the leukemia and
chemotherapy. Given that the patient has a complete absence of any history of
cardiac abnormalities, I am skeptical of this conclusion, and more
inclined to view the tachycardia and "chill" convulsions in light of
the leukemia or chemotherapy. Is there any connection linking these
types of symptoms to chemotherapy / leukemia? or is the most probable
explaination truly and unrelated cardiac condition as the rest of
staff seems to feel?
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-Does sound odd for a congenital heart condition to manifest itself for the
1st time without other symptoms in a 45-yr-old patient, though I'm not a
doctor. What chemo drugs was he on? If you can tell me, I might be able to
find something about them in Medline. Was there any special reason why the
cardiologist came to this conclusion? Did he do some kind of test
(echocardiogram? sestamibi scan?) and see something suspicious? Could the
chills have been associated with infection (very common in leukemia
patients)? Certainly the anthracycline antineoplastic agents (daunorubicin,
aclarubicin, etc.) can cause tachycardia. Rituximab can cause chills. There
are so many antileukemia drugs that it would be impossible to go through
them all, so please let us know which ones were given. -http://www.cancer.org/docroot/CDG/content/CDG_daunorubicin.html
Daunorubicin can cause injury to the heart muscle when large total doses are
given. Your doctor will do a heart function test before you receive your first
treatment, and then during the treatment. This way, any early damage can be found
early. Talk to your doctor about this. http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682289.html
tell your doctor if you have or have ever had heart, liver, or kidney disease. http://www.cancerbacup.org.uk/info/daunorubicin.htm
Changes in the way your heart works. Higher doses of daunorubicin may cause
changes in the muscle of the heart, which can affect how the heart works. The
effect on the heart depends on the dose given. It is very unusual for the heart
to be affected if you have standard doses. Tests to see how well your heart is
working may sometimes be carried out before the drug is given.
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