Cardiovascular Complications of Cancer Therapy: Best Practices in Diagnosis, Prevention, and Management: Part 2

Abstract

In this second part of a 2-part review, we will review cancer or cancer therapy-associated systemic and pulmonary hypertension, QT prolongation, arrhythmias, pericardial disease, and radiation-induced cardiotoxicity. This review is based on a MEDLINE search of published data, published clinical guidelines, and best practices in major cancer centers. Newly developed targeted therapy can exert off-target effects causing hypertension, thromboembolism, QT prolongation, and atrial fibrillation. Radiation therapy often accelerates atherosclerosis. Furthermore, radiation can damage the heart valves, the conduction system, and pericardium, which may take years to manifest clinically. Management of pericardial disease in cancer patients also posed clinical challenges. This review highlights the unique opportunity of caring for cancer patients with heart problems caused by cancer or cancer therapy. It is an invitation to action for cardiologists to become familiar with this emerging subspecialty.

Keywords: cancer therapy; cardiovascular complication; hypertension; radiation therapy; thromboembolism.

Conflict of interest statement

Disclosures: No conflict of interest disclosures for all authors.

Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Figures

Central Illustration. Management of cancer therapy-induced cardiovascular complications

Best practices in the management of cancer therapy-induced HTN, thromboembolism, QT prolongation, and radiation-induced complications. HTN=hypertension; BP= blood pressure; CT= computed tomography; MR= magnetic resonance imaging; LMWH=low-molecular weight heparin; TdP= torsades de Pointe