Cardio-Oncology Service, Barts Health NHS Trust, London, UK
Cardio-Oncology Service, The Hatter Cardiovascular Institute, London, UK.
BMJ Case Rep. 2021 Mar 15;14(3):e239560. doi: 10.1136/bcr-2020-239560.
A 40-year-old man presented to a local hospital with a 2-day history of dyspnoea having been started on adjuvant chemotherapy consisting of oxaliplatin and capecitabine for mucinous adenocarcinoma of the colon. During his admission, he develops chest pain, worsening shortness of breath, and intermittent dysarthria and disorientation. Investigations reveal severely impaired left ventricular function on echocardiogram, bilateral acute pulmonary embolisms on CT pulmonary angiogragraphy, and diffused subcortical and callosal white matter signal change and restricted diffusion consistent with a toxic leukoencephalopathy on MRI of brain. This case highlights the pivotal role of the multidisciplinary cardio-oncology approach which enabled these challenging diagnoses to be made and ensured optimal patient outcome.
一位 40 岁男性因结肠癌黏液性腺癌接受奥沙利铂和卡培他滨辅助化疗后出现呼吸困难，于当地医院就诊，病程为 2 天。在住院期间，他出现胸痛、呼吸困难恶化、间歇性构音障碍和定向障碍。检查发现超声心动图显示左心室功能严重受损，CT 肺动脉造影显示双侧急性肺栓塞，脑 MRI 显示弥漫性皮质下和胼胝体白质信号改变和弥散受限，符合中毒性脑白质病。本病例强调了多学科心脏肿瘤学方法的关键作用，该方法有助于做出这些具有挑战性的诊断，并确保了患者的最佳预后。
