Day | Event |
January 1990 (First presentation) | Admission with stage IIB left breast cancer. A radical mastectomy was performed, followed by radiotherapy and adjuvant chemotherapy based on anthracyclines |
December 2012 (Second presentation) | Admission after an episode of syncope, and atypical chest pain |
April 2013 | 2D-echocardiography revealed left atrial dilation with left ventricular diffuse hypokinesia and a LVEF of 45%, severe mitral regurgitation, moderate tricuspid regurgitation and mild aortic regurgitation. |
May 2013 | Medical treatment based on metoprolol, losartan and furosemide and the patient was discharged. |
December 2013 | Admission due a new episode of syncope, and dyspnea 12-lead electrocardiogram showed a complete left bundle branch block and a Mobitz II atrioventricular block |
December 2013 | Heart Team: Implantation of a dual chamber pacemaker, and was discharged |
December 2013 to January 2020 | Following 2D-echocardiography (3) showed a LVEF of 48% |
January 2020 | 2D-echocardiography reported diffuse left ventricular hypokinesia, eccentric hypertrophy, severe mitral and tricuspid regurgitation, and LVEF of 40%. |
January 2021 | Follow-up echocardiogram demonstrated LV eccentric hypertrophy, diffuse hypokinesia of the LV and mild tricuspid and severe mitral regurgitation, LVEF of 39%, GLS −14%, and intermediate probability of pulmonary hypertension (PSAP of 56 mmHg). |
January 2022 | Last follow-up 2D-echocardiography reported an LVEF of 38%, GLS −10.9%, left atrial reservoir strain 9.5%, free-wall right ventricular longitudinal strain of −19.35% and PSAP of 47 mmHg. |
February 2022 | Outpatient clinic visit: The patient remains asymptomatic with a NYHA functional class II and is currently receiving optimal treatment for heart failure based on sacubitril/valsartan + spironolactone + bisoprolol + furosemide + dapagliflozine |