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Case report
Intermittent left bundle branch block and acute heart failure in trastuzumab-induced cardiotoxicity
  1. Ravi Masson1,
  2. Hooman Bakhshi2 and
  3. Tariq M Haddad2,3
  1. 1Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
  2. 2Department of Cardiology, Inova Heart and Vascular Institute, Falls Church, Virginia, USA
  3. 3Department of Cardiology, Virginia Heart, Falls Church, Virginia, USA
  1. Correspondence to Dr Ravi Masson; ravimasson{at}


A 70-year-old woman with HER2+/ER+ breast cancer on adjuvant trastuzumab therapy without a history of cardiovascular disease presented with respiratory failure from influenza and was found to have intermittent left bundle branch block (LBBB) with new onset systolic heart failure. Her course was complicated by polymorphic ventricular tachycardia and recurrent chest pain. Significant investigations included a normal cardiac MRI and cardiac catheterisation with unobstructed coronaries. It was determined that the aetiology of her heart failure was trastuzumab-induced cardiotoxicity after comprehensive workup. This case highlights an uncommon presentation of LBBB and the steps taken to diagnose a rare cardiomyopathy.

  • cancer - see oncology
  • heart failure
  • breast cancer
  • chemotherapy
  • unwanted effects / adverse reactions

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  • Contributors This work was carried out in collaboration between all authors. RM wrote the first draft of the manuscript. HB and TMH helped obtain figures and assisted with revisions. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.