Chemotherapeutics especially anthracycline derivatives have serious cardiac side effectswhich are generally occur by cumulative doses at chronic phase. It should be noted that this effectmay also occur at low doses. An 30 years old female patient with a diagnosis of osteosarcoma wasmedicated totally 102 mg adriamycin as neoadjuvant chemotherapy. After first session ofchemotherapy application; respiratory distress , electrocardiography changes, bilateral fluid overload in chest x ray developed and patient was hospitalized with acute heart failure diagnosis to ourintensive care unit. Enalapril maleate and metoprolol were added to the medication to prevent earlyremodeling soon after the ejection fraction increased and the cardiac enzymes were started to decrease. The patient was discharged to oncology service after successful weaning and extubation.Regular cardiac follow-up during the chemotherapy process protects the patients from side effectsof this drugs.