Cardiotoxic

Cardiotoxicity
Specialty	Cardiology, Toxicology
Causes	Exposure to cardiotoxic substances

Cardiotoxicity refers to damage to the heart by harmful chemicals. As a significant side effect of various substances, including both chemotherapeutic agents and toxins, cardiotoxicity can lead to severe cardiac dysfunction and may be fatal.

Causes

Cardiotoxicity can be caused by numerous agents including:

• Chemotherapy drugs, such as anthracyclines (e.g., doxorubicin), cyclophosphamide, and trastuzumab
• Radiation therapy directed at or near the heart
• Some antibiotics
• Heavy metals such as arsenic and lead
• Lifestyle factors and other medications

Mechanism

The mechanism of cardiotoxicity varies depending on the causative agent. For example, anthracyclines cause oxidative stress leading to damage of the myocardial cells. Trastuzumab, an antibody used in cancer therapy, can lead to dysfunction of the heart muscle by interfering with its growth signals.

Symptoms

Symptoms of cardiotoxicity may include:

• Shortness of breath
• Fatigue
• Edema (swelling)
• Arrhythmias
• Chest pain

Diagnosis

Diagnosis of cardiotoxicity generally involves:

• Medical history and physical examination
• Echocardiogram to assess heart function
• Blood tests to measure cardiac biomarkers
• Electrocardiogram (ECG) to detect heart rhythm abnormalities

Prevention and Treatment

Prevention of cardiotoxicity involves regular monitoring of heart function during treatment with known cardiotoxic agents. Treatment may include:

• Modification or discontinuation of the offending drug
• Medications to manage symptoms and prevent further damage
• Lifestyle changes and possibly cardiac rehabilitation

Prognosis

The prognosis for cardiotoxicity varies depending on the extent of the heart damage and the effectiveness of mitigating treatments. Early detection and management are crucial.

See also

• Cardiology
• Toxicology
• Chemotherapy-induced cardiotoxicity
• Drug-induced cardiomyopathy