Outcome and Follow-up
She was diagnosed with osimertinib-induced acute heart failure due to
TC. She was admitted to our institution on the same day for treatment of
cardiac failure. Her condition improved after discontinuing osimertinib
and adding treatment for heart failure.
Thirty-five days after admission, left ventricular wall motion
abnormality improved to almost normal kinesis (Fig 1(C, D)), and
electrocardiogram showed ST changes normalized after extensive negative
T waves (Fig 2(C, D)). She improved from class IV to class II as per the
New York Heart Association classification.
Since osimertinib was highly effective against lung cancer, the
treatment was restarted at a reduced dose of 40 mg/day. After 63 days of
restarted osimertinib therapy, an echocardiogram showed hypokinesis on
the left ventricular apical portion (Fig 1(E, F)). Electrocardiogram
showed reappearance of extensive negative T waves (Fig 2(E)). She was
diagnosed with asymptomatic TC, and osimertinib treatment was
subsequently stopped. Two weeks after stopping osimertinib, left
ventricular wall motion improved to normal. She was started on
3rd-line chemotherapy.