Cardiotoxicity

What is cardiotoxicity?

Advances in cancer treatment are allowing more people to survive cancer. Currently in the United States, two of every three people diagnosed with cancer survive at least five years, and the number of cancer survivors is more than 14 million strong.

Unfortunately, cancer treatment can sometimes worsen an existing heart problem or create a new one. This happens when a cancer drug or radiation therapy causes unintended harm to the heart or blood vessels and is called cardiotoxicity.

Symptoms of cardiotoxicity

Side effects from cancer treatment can lead to heart failure, valve disease, heart attack, dangerously unsafe blood pressure levels or other problems. These problems may develop during, soon after or years following cancer treatment.

If you're having heart problems related to cardiotoxicity, you may experience the following symptoms:

  • Chest pain
  • Shortness of breath
  • Fatigue
  • Dizziness and fainting
  • Irregular heartbeat

Causes of cardiotoxicity

Cardiotoxicity can be caused by chemotherapy drugs, which can attack healthy cells in addition to cancer cells and cause long-term damage to the heart.

Additionally, environmental toxins such as heavy metals, alcohol and tobacco smoke can also contribute to cardiotoxicity. Other factors such as genetic predisposition, pre-existing heart conditions and radiation therapy can also increase the risk of cardiotoxicity.

It's important to monitor and minimize exposure to these risk factors to help protect heart health.

Who can benefit from cardio-oncology care

Cancer affects people differently, and treatments vary significantly from person to person. Not everyone will need specialized heart care. Cardio-oncology care can benefit:

  • People diagnosed with cancer who have or are at risk for heart problems and need treatment that may pose a risk to their heart or blood pressure.
  • People who develop new heart problems during cancer treatment.
  • Cancer survivors who previously received cancer treatment that may pose a risk to their heart or blood pressure.

Diagnosis and testing for Cardiotoxicity

What's important to know is that many of the adverse effects of cancer treatment on the heart, although unintended, can be anticipated and therefore monitored, managed or avoided altogether.

Cardiotoxicity can be diagnosed in several ways depending on the underlying cause of the condition. For instance, the symptoms may be identified by performing physical examinations such as electrocardiograms (ECGs) or echocardiograms. Cardiac MRI or CT scans may also be ordered to examine the heart's structure and function. Furthermore, cardiac biopsies or blood tests can detect abnormal levels of enzymes, proteins or hormones that may indicate cardiotoxicity.

Cardiovascular clinical trials at Main Line Health

Main Line Health uses clinical trials to help prevent, diagnose and treat the full range of heart and vascular conditions. Learn more about the cardiovascular clinical trials currently being offered by our renowned cardiologists and heart and vascular surgeons.

Treatments

To address cardiotoxicity, Lankenau Heart Institute cardiologists with expertise in cancer-related heart problems are working with oncology colleagues across Main Line Health to coordinate cancer treatment with heart care. This specialized area of heart care, called cardio-oncology, is a new field that has emerged as a result of growing awareness of the possible heart complications of cancer treatment. Our cardio-oncology specialists and services are available at locations throughout the suburbs of Philadelphia.

The Main Line Health Cardio-Oncology Program is devoted to protecting heart health after a cancer diagnosis. The cardio-oncology team keeps pace with advances in the field, integrating the latest techniques and strategies for identifying, preventing and managing heart complications in patients undergoing cancer treatment or being followed in cancer surveillance programs.

Our goal is to:

  • Reduce the risk of heart damage in patients who have heart problems prior to cancer treatment.
  • Monitor for heart damage in patients receiving potentially harmful cancer treatments.
  • Promptly treat heart problems related to cancer treatments to allow completion of cancer therapy.
  • Detect and treat heart problems in cancer survivors who received potentially harmful cancer treatments.

Angiotensin-Converting Enzyme Inhibitors

A type of vasodilator, these drugs widen blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart.

Aldosterone Antagonists

Aldosterone antagonists are primarily potassium-sparing diuretics, but they have additional properties that help the heart work better.

Beta Blockers

These drugs reduce signs and symptoms of heart failure, improve heart function and help extend patients’ lives.