ArticleJACC. Case reports2026
Life-Threatening Cardiogenic Shock During Chemotherapy: The Role of Mechanical Ventricular Support in Cardio-Oncology Patients.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute cardiogenic shock is a possible and life-threatening complication of anthracycline therapy. Data on the use of percutaneous mechanical circulatory support in this setting remain limited. CASE SUMMARY: A 50-year-old woman developed cardiogenic shock 2 days after receiving epirubicin-based chemotherapy. Owing to progressive hemodynamic instability despite inotropic support, an Impella CP was needed. Extracorporeal membrane oxygenation (ECMO) was avoided given chemotherapy-related pancytopenia and the need to minimize bleeding risk. Progressive hemodynamic recovery was achieved, with normalization of biventricular function at follow-up. DISCUSSION: This case illustrates acute, reversible anthracycline-induced cardiotoxicity managed with mechanical circulatory support. In thrombocytopenic cardio-oncology patients, a stepwise approach with inotropes and Impella device may represent a safer alternative to ECMO. Early and tailored interventions are key in this high-risk population. TAKE-HOME MESSAGES: Anthracycline-induced cardiotoxicity may be acute and unpredictable. In cardio-oncology patients with high bleeding risk, an Impella device may represent a safer and effective alternative to ECMO for circulatory support.
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