Delayed Onset Anthracycline-Associated Cardiotoxicity Presenting as Acute Decompensated Heart Failure Seven Years After Chemotherapy Completion

Anthracyclines are a class of chemotherapeutic agents commonly used to treat a variety of malignancies including leukemias and lymphomas. Cardiotoxicity is a well-known clinical adverse effect of anthracyclines with a diverse range of presentations and manifestations. While the vast majority of cardiotoxicity from anthracyclines presents acutely during or within one year after chemotherapy, they rarely cause long-term effects several years after. Here, we present a case of sudden and delayed onset doxorubicin-associated cardiotoxicity seven years following chemotherapy completion. We review important and evidence-based clinical diagnostic workup and management strategies for atypical anthracycline-associated cardiotoxicity in a young patient with acute decompensated heart failure.