Alessandro Pastorino, Giacomo Bregni, Azzurra Damiani, Massimiliano Grassi, Alberto Puccini and Giuseppe Fornarini
Introduction: Cisplatin-related arrhythmias are not routinely described in the literature and their cardiac complications can lead to relevant hemodynamic events that could compromise the administration of chemotherapy and, above all, they could cause life threatening consequences.
Methods: A 37-year-old man with stage II B testicular seminoma was admitted to our department. The patient had a negative cardiologic history, blood count and chemistry were within normal limits except for hypomagnesaemia, and hence PEB chemotherapy was started. During cisplatin infusion, the patient experienced pulse arrhythmia with EKG diagnosis of atrial fibrillation.
Results: Despite the finding of atrial fibrillation, thanks to digoxin infusion and magnesium supplementation, chemotherapy was completed and on the next morning the heartbeat was rhythmical again.
Conclusion: One of the most important causes of arrhythmia is electrolytic imbalance and, for this reason, sodium, potassium, calcium, chlorine and magnesium plasmatic levels should be accurately checked before, during and after chemotherapy. In particular, magnesium seems to have a dominant role in the generation of arrhythmias during cisplatin-based chemotherapy because this antineoplastic compound increases ionic renal waste due to tubular damage. This case gives strength to the role of oral and intravenous electrolytes supplementation during platinumbased chemotherapy.
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