A 55-year-old woman receiving adjuvant trastuzumab for HER2-positive breast cancer develops progressive exertional dyspnoea. Which baseline and on-treatment monitoring modality detects the characteristic toxicity earliest?
- A Serial troponin I levels every 3 months
- B Annual coronary angiography
- C Echocardiographic assessment of left ventricular ejection fraction ✓
- D Holter monitoring for arrhythmia
Explanation
Trastuzumab inhibits HER2 signalling that is needed for cardiac myocyte survival and repair, producing a type II (non-dose-dependent, largely reversible) cardiomyopathy distinct from the type II profile contrast often confused with anthracycline injury. Baseline LVEF measurement with serial echocardiography every three months is standard, and treatment is held if LVEF falls significantly below baseline or under 50 percent. Troponins are not validated for routine monitoring here, and the lesion is functional ventricular dysfunction rather than coronary or conduction disease.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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