A Potential Bidirectional Interaction Between Heart Failure and Cancer Progression: Insights From Two Rapidly Fatal Cases.
6 affiliations
- 1Medical Oncology, King Abdulaziz Specialist Hospital, Taif, SAU.
- 2Medical Oncology, King Abdulaziz Specialist Hospital, TAIF, SAU.
- 3Radiology, King Abdulaziz Specialist Hospital, Taif, SAU.
- 4Pathology, King Abdulaziz Specialist Hospital, Taif, SAU.
- 5Internal Medicine, New York Medical College / Metropolitan Hospital, New York, USA.
- 6Oncology, King Abdulaziz Specialist Hospital, Taif, SAU.
Abstract
The interaction between malignancy and cardiovascular disease is increasingly recognized in cardio-oncology. While cancer therapy-related cardiac dysfunction is well established, a potential bidirectional relationship between heart failure (HF) and cancer progression remains underexplored. We present the cases of two patients without known cardiovascular disease who developed new-onset HF in temporal association with rapidly progressive metastatic malignancies. A 65-year-old man with metastatic pancreatic adenocarcinoma developed severe left ventricular (LV) systolic dysfunction with a left ventricular ejection fraction (LVEF) of 30%, apical akinesis, and suspected LV thrombus after a previously normal cardiac evaluation. A 44-year-old man with metastatic esophageal squamous cell carcinoma developed severe LV systolic dysfunction (LVEF 25-30%) with global hypokinesia, also following a normal baseline cardiac assessment. In both cases, baseline electrocardiography, troponin levels, and echocardiography were normal, whereas B-type natriuretic peptide (BNP) levels became elevated during rapid tumor progression. Both patients experienced rapid clinical deterioration and died within weeks of diagnosis. These cases highlight a potential interaction between aggressive malignancy and cardiac dysfunction, possibly mediated by inflammatory, metabolic, and neurohormonal mechanisms. Conversely, HF may adversely affect oncologic outcomes by reducing physiological reserve and limiting therapeutic options. Although causality cannot be established from these observations, new-onset HF occurring alongside rapidly progressive malignancy may represent an underrecognized clinical phenomenon with important prognostic implications.
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BibTeX
@article{djerouni2026potential,
title = {{A Potential Bidirectional Interaction Between Heart Failure and Cancer Progression: Insights From Two Rapidly Fatal Cases.}},
author = {Mohamed Djerouni and Ramy Abbas and Soufiane Khelifi Touhami and Omar Alotaibi and Fouzia Kauser and Wael Abdelmottaleb and Abdulrahman Alrubayee},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116668},
url = {https://europepmc.org/article/MED/42910362},
note = {CC BY},
}
RIS
TY - JOUR
TI - A Potential Bidirectional Interaction Between Heart Failure and Cancer Progression: Insights From Two Rapidly Fatal Cases.
AU - Mohamed Djerouni
AU - Ramy Abbas
AU - Soufiane Khelifi Touhami
AU - Omar Alotaibi
AU - Fouzia Kauser
AU - Wael Abdelmottaleb
AU - Abdulrahman Alrubayee
PY - 2026
DA - 2026/09/21
JO - Cureus
DO - 10.7759/cureus.116668
UR - https://europepmc.org/article/MED/42910362
AB - The interaction between malignancy and cardiovascular disease is increasingly recognized in cardio-oncology. While cancer therapy-related cardiac dysfunction is well established, a potential bidirectional relationship between heart failure (HF) and cancer progression remains underexplored. We present the cases of two patients without known cardiovascular disease who developed new-onset HF in temporal association with rapidly progressive metastatic malignancies. A 65-year-old man with metastatic pancreatic adenocarcinoma developed severe left ventricular (LV) systolic dysfunction with a left ventricular ejection fraction (LVEF) of 30%, apical akinesis, and suspected LV thrombus after a previously normal cardiac evaluation. A 44-year-old man with metastatic esophageal squamous cell carcinoma developed severe LV systolic dysfunction (LVEF 25-30%) with global hypokinesia, also following a normal baseline cardiac assessment. In both cases, baseline electrocardiography, troponin levels, and echocardiography were normal, whereas B-type natriuretic peptide (BNP) levels became elevated during rapid tumor progression. Both patients experienced rapid clinical deterioration and died within weeks of diagnosis. These cases highlight a potential interaction between aggressive malignancy and cardiac dysfunction, possibly mediated by inflammatory, metabolic, and neurohormonal mechanisms. Conversely, HF may adversely affect oncologic outcomes by reducing physiological reserve and limiting therapeutic options. Although causality cannot be established from these observations, new-onset HF occurring alongside rapidly progressive malignancy may represent an underrecognized clinical phenomenon with important prognostic implications.
SN - 2168-8184
ER -