Age (years) | Gender | Pazopanib dose at time of event (mg) | Cardiac drugs at event | Time until event (days) | Type of Cardiovascular event | Past cardiac history and clinical synopsis | Notable cardiac diagnostic findings | Outcome |
---|---|---|---|---|---|---|---|---|
67 | Male | 800 | None | 30 | Cardiogenic Shock | H/O grade II diastolic dysfunction and 2nd degree AV block SP PPM. SB at rest and LE edema. BNPÂ =Â 2567. Troponin normal. | LVEF decline noted from 56% pre-pazopanib to 27% after pazopanib. No wall motion abnormalities detected on TTE. | Pazopanib discontinued on admission. Treated with furosemide with initial improvement but developed cardiogenic shock and subsequent PEA arrest and death. |
60 | Female | 800 | None | 16 | Acute HFrEF | No previous cardiac history. SB, orthopnea. JVP elevated. BNPÂ =Â 3712. Troponin normal. | LVEFÂ =Â 10% on CMR. No previous LVEF available for comparison. Mid-myocardial fibrosis and elevated extracellular volume fraction of 35% (normal <29%) suggestive of non-ischemic cardiomyopathy | Pazopanib discontinued. Treated with IV furosemide and started GDMT. Re-admitted two weeks later for hypotension and uncontrolled cancer-related pain. Due to hypotension was unable to tolerate GDMT for HFrEF. |
59 | Male | 800 | Atorvastatin, furosemide, ramipril, pioglitazone, metformin, warfarin | 37 | Atrial flutter | H/O HTN, DM, HLD developed new-onset atrial flutter 12Â days after spinal and hip surgery for metastatic bone cancer. | LVEF 55-60% on TEE. EPS confirmed the mechanism of tachycardia to be right atrial flutter within the cavo-tricuspid isthmus. | Successful TEE-guided DCCV restored normal sinus rhythm, followed by ablation. Patient deceased nine months after event due to progression of malignancy. |
85 | Female | 800 | Aspirin, diltiazem, simvastatin | 662 | Ischemic Left Lower Extremity | H/O CAD, CVA, HLD, HTN, PAD with two prior percutaneous interventions to lower extremities preceding pazopanib initiation. Developed left leg pain. Non-emergent presentation. | Totally occluded left popliteal artery. Multiple 70-80% stenotic lesions of the left superficial femoral artery. Occlusion of the left peroneal artery. | Successful percutaneous intervention. Pazopanib was continued without any recurrent ischemic events for the remainder of the study period. |