A Case of Acute Right Heart Failure With Severe Pulmonary Hypertension Associated With Doxorubicin

We present a 58-year-old woman with metastatic lobular carcinoma on long-term doxorubicin with appropriate cardiovascular surveillance presenting with dyspnea and orthopnea. An echocardiogram and right heart catheterization revealed severe pulmonary hypertension and acute right heart failure. Her cumulative doxorubicin dose was 1.145 g/m2. Doxorubicin was withdrawn and guideline-directed medical therapy and antipulmonary hypertensive therapy was started. A follow-up right heart catheterization showed a recovered cardiac output and improved variables. This case highlights the importance of considering right-sided heart failure as a rare but serious complication in patients receiving doxorubicin, which warrants closer cardiovascular monitoring.