Cardiac Toxicity

What is cardiac toxicity?

Cardiac (heart) toxicity is a side effect of cancer treatment that causes damage to the heart muscle or valves. Both chemotherapy and radiation can lead to cardiac toxicity, based on the type of medication(s) you had and where radiation treatment was given. Cardiac toxicity can be a late effect of treatment and can happen months to years after treatment has ended.

Cancer treatments not only kill cancer cells but also harm or kill healthy cells. When these cells are in or around the heart, cardiac toxicity happens. Types of cardiac injury are:

• Cardiomyopathy: Disease of the heart that makes it hard for the heart to carry blood to the body.
• Myocarditis: Inflammation (swelling) of the heart muscle, which lowers the heart’s pumping ability and can cause arrhythmias (problems with the rate or rhythm of the heart).
• Pericarditis: Swelling of the pericardium (the saclike membrane that surrounds the heart).
• Acute coronary syndromes: Blood flow is slowed or stopped to the heart, which happens suddenly.
• Congestive heart failure (CHF): The heart can’t pump or fill enough.

Older people, young children, and women are at greater risk of getting cardiac toxicity. Those with other health issues, as well as with a history of cardiac problems are also at higher risk. Symptoms of cardiac toxicity may be:

• Chest pain.
• Heart rhythm changes (arrhythmia).
• Fatigue.
• Shortness of breath.
• Weight gain.
• Swelling.

If you are having any of these signs or symptoms, your care team will order tests and blood work to see how well your heart is working.

How is cardiac toxicity treated?

Treatments for cardiac toxicity include lowering your dose of chemotherapy (if you are still in treatment), using medications such as diuretics (to control too much fluid in the body), ACE inhibitors/beta-blockers (for blood pressure control), and/or medication to keep your heart rhythm regular and to strengthen your heart.

You can also help manage cardiac toxicity by:

• Using your energy wisely. Plan your activities and schedule them around the time of day when you have the most energy.
• Exercising safely. Regular (light) exercise can help your heart muscles get stronger. Talk with your provider before starting any exercise program.

When should I call my care team?

If you are having cardiac toxicity symptoms listed above, call your care team right away. If you have sudden chest pain or shortness of breath, call 911 right away.