Figure 11b. Doxorubicin-induced cardiotoxicity in a 46-year-old woman who had undergone left MRM and adjuvant chemotherapy that included four cycles of doxorubicin. (a) Chest radiograph shows enlargement of the cardiac silhouette. (b) Chest CT scan shows global enlargement of the cardiac chambers and a small amount of pericardial effusion (arrows). Echocardiography demonstrated a decreased LV ejection fraction (25%) with severe LV dysfunction and LV dilatation, as well as enlargement of both atria. The total cumulative dose of doxorubicin was 360 mg/m2.