Cardiovascular Toxicity Related to Cancer Treatment

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  Figure 1. The four pillars of cardiotoxicity management in patients on anti-cancer treatments. Several anti-cancer treatments (anthracyclines, HER2i, VEGF, etc.) were associated with unfavorable cardiovascular events such as myocarditis, cardiomyopathy, hypertension, arrhythmias, prothrombotic events, and bleeding. Therefore, implementation of cardio-oncology programs to prevent, monitor, and manage cardiotoxicity in patients requiring anti-cancer treatments is crucial, and it is based on four pillars. The first pillar is prevention (both primary and secondary). Lifestyle changes such as Mediterranean diet, weight loss, and aerobic exercise along with medical treatment (antihypertensive, antidiabetic, antilipidemic) may reduce the risk of cardiotoxicity. The second pillar is diagnosis and follow up. In this regard, medical history (age, smoking, obesity, cardiovascular risk factors, heart failure, type and dose of chemotherapy), echocardiography (left ventricular ejection fraction, global longitudinal strain), and biomarkers (cardiac troponin and natriuretic peptides) should be an integral part of patient’s evaluation at the first visit and during follow-up. The third pillar encompasses…