Cardiotoxicity

Cardiotoxicity
Specialty	Cardiology, Oncology
Causes	Exposure to cardiotoxic agents
Diagnostic method	Echocardiogram, Electrocardiogram, Blood tests

Cardiotoxicity refers to damage to the heart by harmful chemicals. As a significant side effect of certain medications, particularly chemotherapy agents and other drugs, it poses a serious risk for patients undergoing treatment for various conditions, including cancer. The understanding and management of cardiotoxicity are crucial in the fields of cardiology and oncology.

Causes

Cardiotoxicity can be caused by numerous agents including:

• Chemotherapy drugs, such as anthracyclines (e.g., doxorubicin), and monoclonal antibodies (e.g., trastuzumab)
• Radiation therapy, especially when the heart is within the radiation field
• Some targeted therapies and other medications, such as tyrosine kinase inhibitors
• Excessive exposure to certain environmental toxins

Mechanisms

The mechanisms of cardiotoxicity vary depending on the causative agent. For example, anthracyclines induce cardiotoxicity primarily through the generation of free radicals, which damage the cardiac muscle. Trastuzumab, on the other hand, can lead to heart dysfunction by interfering with HER2 signals, which are important for heart cell survival and repair.

Symptoms

Symptoms of cardiotoxicity may include:

• Heart failure
• Arrhythmias
• Cardiomyopathy
• Ischemia

Diagnosis

Diagnosis of cardiotoxicity generally involves:

• Echocardiogram to assess heart function
• Electrocardiogram (ECG) to monitor heart rhythm
• Blood tests to measure cardiac biomarkers

Prevention and Management

Prevention and management strategies for cardiotoxicity include:

• Regular monitoring of heart function during and after treatment
• Use of cardioprotective agents
• Dose modification or discontinuation of the cardiotoxic drug

Prognosis

The prognosis for patients with cardiotoxicity varies based on the severity of the damage and the response to management strategies. Early detection and intervention are critical for improving outcomes.

See also

• Chemotherapy-induced cardiotoxicity
• Radiation-induced heart disease
• Drug-induced heart disease

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