CardioBird

 

Welcome back to our series, “The Turning Point,” where we share real cases from your colleagues that demonstrate how an ECG can dramatically alter patient management. This edition focuses on a critical aspect of comprehensive oncology care: monitoring for chemotherapy-induced cardiotoxicity.

 

The Patient: A 10-year-old mixed-breed dog receiving doxorubicin for lymphoma.

 

The Presenting Signs: The patient was responding excellently to chemotherapy, with its lymphoma in complete remission. It was bright, alert, and responsive during its visit for the fourth doxorubicin dose. Physical examination revealed no murmurs or arrhythmias on auscultation, and the owner reported no signs of coughing, weakness, or exercise intolerance.

 

The Turning Point – The Pre-Chemotherapy ECG: Following the clinic’s standard protocol, a CardioBird ECG was performed prior to drug administration. The AI analysis and subsequent cardiologist second review identified a significant change from the baseline ECG taken before treatment started: the trace now showed frequent ventricular premature complexes (VPCs) in a bigeminal pattern.

 

ECG Findings & Critical Difference:
The development of a ventricular arrhythmia in a previously normal heart, temporally associated with doxorubicin administration, was highly indicative of drug-induced cardiotoxicity. This was a subclinical finding—the ECG provided the only warning sign. Without it, the patient would have received another dose of a potentially damaging drug, increasing the risk of progressive, irreversible myocardial damage and dilated cardiomyopathy.

This “turning point” ECG finding led to an immediate and critical change in the treatment plan. The scheduled doxorubicin dose was withheld. The patient was started on a cardioprotective medication and referred for an echocardiogram to assess myocardial function. The oncology protocol was successfully switched to a non-cardiotoxic alternative, allowing cancer treatment to continue while safeguarding the patient’s cardiac health.

 

Your Takeaway:
This case highlights a vital protocol for any patient receiving potentially cardiotoxic chemotherapeutics like doxorubicin:

1. Establish a Baseline: A pre-treatment ECG is essential. It provides the reference point needed to identify subtle, yet significant, changes later on.
2. Monitor Before Every Dose: An ECG before each subsequent dose of a cardiotoxic drug is your most sensitive tool for detecting subclinical toxicity, often long before clinical signs or echocardiographic changes appear.
3. Let ECG Guide the Protocol: The emergence of significant arrhythmias (like VPCs) or changes in complex morphology provides the objective evidence needed to pause treatment, initiate cardioprotective strategies, or alter the oncology plan, thereby preventing life-altering cardiac complications.

By integrating routine ECG monitoring into your oncology patients’ care, you are proactively protecting their heart. You are part of a global community using technology to fight cancer with greater precision and safety, ensuring we can extend life without compromising its quality.

 

Have a “Turning Point” case of your own? We’d love to feature it. Share your story with us.