A 45-year-old woman underwent a modified radical mastectomy 4 years ago. She was treated for multiple bone metastases with cyclophosphamide, doxorubicin, and fluorouracil for 6 months. She is complaining of exertion on exercise, swelling of the legs, and swelling around eyes in the morning. On examination, she has bilateral rales in the lungs, S1, S2 audible, S3, S4 gallop present. Her BP is 149/117 mm Hg, PR is 80/min, and RR is 18/min. What is the most likely cause for her cardiac condition?

Ans. is 'b' i.e. Drug-induced cardiac toxicity A woman with H/O doxorubicin intake and presenting with complaints of congestive cardiac failure suggests cardiac toxicity due to doxorubicin.Doxorubicin causes cardiac toxicity which can manifest either acutely with ECG changes, arrhythmias, and hypotension or be delayed, and present with congestive heart failure.Congestive cardiac failure occurs due to cardiomyopathy.About 5% of the patients who receive > 550 mg/m2 of doxorubicin will develop congestive cardiac failure.