Abstract

Azacitidine (AZA) is the first choice of low-intensity treatment in myelodysplastic syndrome. Its most serious adverse effect is myelosuppression whilst cardiac complications are poorly identified. Despite the NICE guidelines encourage not to use AZA in severe congestive heart failure (HF), more data should be provided. We present a new AZA’s complication: this is the first left ventricular dysfunction due to AZA’s treatment in a patient with no previous cardiac history. Transthoracic echocardiogram examination was key to discontinue AZA and to initiate treatment for ventricular dysfunction. In such circumstances, cardiac follow-up is mandatory, strengthening the multidisciplinary management in oncology patients.