Cardiac Dysfunction - Prevention and Monitoring in Cancer Survivors

Publication Date: December 5, 2016

Key Points

Key Points

Cardiac dysfunction is a serious side effect of certain cancer-directed therapies that can interfere with the efficacy of treatment, decrease quality of life, or impact the actual survival of the cancer patient.

Heart failure (HF), presenting during or after completion of cancer treatment, is a well-recognized complication that begins with risk factors known to be associated with the development of HF, including the toxicity of chemotherapy and/or radiation (stage A), and is commonly progressive after structural changes to the heart occur.

The initial manifestation may be asymptomatic.

Onset may also be responsible for interruption or discontinuation of cancer-directed therapy, potentially reducing the chance for long-term survival.

Risk

...isk

...is recommended that cancer patients who meet...


...tion can be made on the risk of car...


Prevention

Prevention

...ntion PRIOR TO Initiation of The...

...d or minimize the use of potentially cardioto...

...ould perform a comprehensive assessment i...


...ention DURING Potentially Cardiotoxi...

...nicians should screen for and activ...

...ians may incorporate a number of strate...

...or patients who require mediastinal RT which mi...


Surveillance

...eillance...

...nitoring During Tre...

...d complete a careful history and physical exam...

...mendation 4.2...

...ram for diagnostic work-up ( EB , H , B , M )3...

...magnetic resonance imaging (MRI) or multi-g...

...ac biomarkers (troponins, natriuretic peptides) or...

...rdiologist based on findings. (EB, B, M, I)3336...

...e surveillance imaging may be offered during tr...

...ions can be made regarding continuation/disc...

...ns may use routine echocardiographi...


Monitoring After Trea...

...ns should complete a careful history and physic...

Recommendation 5....

...rdiogram for diagnostic work-up ( EB , H , B...

...diac MRI or MUGA if echocardiogram is...

...erum cardiac biomarkers (troponins, natr...

...eferral to a cardiologist based on...

...cardiogram may be performed 6–12 m...

...MUGA may be offered for surveillanc...

...ified to have asymptomatic cardiac dysfunc...

No recommendations can be made regarding t...

...uld regularly evaluate and manage cardiovascula...