School of Medicine and Health Sciences, Internal Medicine Program, Fundación Cardioinfantil, Universidad del Rosario, Carrera 24 #63C-69, Bogotá, Colombia.
Fundación Cardioinfantil, Universidad del Bosque, Bogotá, Colombia.
BMC Cardiovasc Disord. 2021 Mar 12;21(1):136. doi: 10.1186/s12872-021-01945-3.
Abiraterone is a medication frequently used for metastatic castrate-resistant prostate cancer. We report a case of non-sustained episodes of TdP associated with severe hypokalemia due to androgen-deprivation therapy. Few case presentations describe this association; the novelty lies in the potentially lethal cardiovascular events among cancer patients receiving hormonal therapy.
A 70-year-old male presented with recurrent syncope without prodrome. ECG revealed frequent ventricular ectopy, non-sustained episodes of TdP, and severe hypomagnesemia and hypokalemia. During potassium and magnesium infusion for repletion, the patient underwent temporary transvenous atrial pacing. As part of the work-up, coronary angiography revealed a mild coronary artery disease, and transthoracic echocardiogram showed a moderately depressed ejection fraction. After electrolyte disturbances were corrected, the QT interval normalized, and transvenous pacing was no longer necessary. Abiraterone was discontinued during the admission, and the patient returned to baseline.
Cancer treatment is complex and requires a multidisciplinary approach. We presented a case of non-sustained TdP associated with androgen-deprivation therapy in an elderly patient with mild coronary artery disease and moderately reduced ejection fraction. Close follow-up and increased awareness are required in patients with hormonal treatment, especially in the setting of other cardiovascular risk factors.
阿比特龙是一种常用于转移性去势抵抗性前列腺癌的药物。我们报告了一例与雄激素剥夺治疗相关的严重低钾血症引起的非持续 Tdp 发作的病例。很少有病例报告描述这种关联；新颖之处在于接受激素治疗的癌症患者中潜在的致命性心血管事件。
一名 70 岁男性因反复晕厥无先兆而就诊。心电图显示频繁室性早搏、非持续 Tdp 发作和严重低镁血症和低钾血症。在进行补钾和补镁治疗时，患者接受了临时经静脉心房起搏。在检查过程中，冠状动脉造影显示轻度冠状动脉疾病，经胸超声心动图显示中度射血分数降低。电解质紊乱纠正后，QT 间期正常化，不再需要经静脉起搏。入院期间停用阿比特龙，患者恢复基线水平。
癌症治疗复杂，需要多学科方法。我们报告了一例与雄激素剥夺治疗相关的非持续 Tdp 发作的病例，该病例发生在一名患有轻度冠状动脉疾病和中度射血分数降低的老年患者中。需要对接受激素治疗的患者进行密切随访和提高认识，尤其是在存在其他心血管危险因素的情况下。
