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Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 33-year-old man is being evaluated for malaise and fatigability. He says that he hasn’t been able to perform at work, can’t exercise like before, and is constantly tired. He also says that his clothes have ‘become larger’ in the past few months. Past medical history is significant for gastroesophageal reflux disease, which is under control with lifestyle changes. His blood pressure is 110/70 mm Hg, the temperature is 37.0°C (98.6°F), the respiratory rate is 17/min, and the pulse is 82/min. On physical examination, an enlarged, painless, mobile, cervical lymph node is palpable. A complete blood count is performed.
Hemoglobin 9.0 g/dL
Hematocrit 37.7%
Leukocyte count 5,500/mm3
 Neutrophils 65%
 Lymphocytes 30%
 Monocytes 5%
Mean corpuscular volume 82.2 μm3
Platelet count 190,000 mm3
Erythrocyte sedimentation rate 35 mm/h
C-reactive protein 8 mg/dL
A biopsy of the lymph node is performed which reveals both multinucleated and bilobed cells. The patient is started on a regimen of drugs for his condition. Echocardiography is performed before treatment is started and shows normal ejection fraction, ventricle function, and wall motion. After 2 rounds of chemotherapy, another echocardiography is performed by protocol, but this time all heart chambers are enlarged, and the patient is suffering from severe exertion dyspnea. Which of the drugs below is most likely responsible for these side effects?
assistant
Adriamycin